| Noncolligative properties of intravenous fluids. | |
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MedLine Citation:
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PMID: 20601866 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: Currently available crystalloids were designed over a century ago for dehydration and not for the treatment of hemorrhagic shock. Information regarding fluids used for resuscitation has grown and thus resuscitation has changed radically in the last two decades. Artificial fluids such as crystalloids and other solutions typically used for resuscitation are now recognized to be inflammatory when infused at high volumes to replace blood. RECENT FINDINGS: Recent studies have shown that the crystalloids and artificial colloids cause inflammation. Prehospital fluid use has not shown to be of benefit and permissive hypotension may be useful. Careful titration of fluids with minimizing crystalloids and early use of blood products have improved outcome after traumatic hemorrhagic shock. SUMMARY: Seemingly innocuous fluids have a dose effect and can be detrimental. Crystalloids can create inflammation when used at high volumes and may be the reason for the sequelae seen after massive resuscitation. This has led to the recognition that whole blood is extremely complex and does much more than carry oxygen. Resuscitation has changed recently with the adoption of damage control resuscitation which is the practice of allowing permissive hypotension, minimizing crystalloids and early aggressive use of blood products. This has led to a decrease in multiple organ dysfunction syndrome and acute respiratory distress syndrome. |
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Authors:
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Peter Rhee |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in critical care Volume: 16 ISSN: 1531-7072 ISO Abbreviation: Curr Opin Crit Care Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9504454 Medline TA: Curr Opin Crit Care Country: United States |
Other Details:
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Languages: eng Pagination: 317-22 Citation Subset: IM |
Affiliation:
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University of Arizona, Tucson, Arizona 85724-5063, USA. prhee@surgery.arizona.edu |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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