BACKGROUND Normal saline (NS) is the most commonly used crystalloid solution worldwide but contains an excess of chloride and may cause metabolic acidosis and hyperchloraemia. Such abnormalities may be attenuated by the use of a balanced solution such as Plasma-Lyte 148 (PL-148). OBJECTIVE To assess the feasibility, safety and biochemical and physiological effects of resuscitation with NS ver...

The use of hydroxyethyl starch (HES) in sepsis has been shown to increase mortality and acute kidney injury. However, the knowledge of the exact mechanism by which several fluids, especially starch preparations may impair end-organ function particularly in the kidney, is still missing. The aim of this study was to measure the influence of different crystalloid and colloid fluid compositions on ...

UNLABELLED Although the distribution of various crystalloid and colloid solutions at equilibrium has been well established, the acute peak expansion of intravascular volume that can be achieved with the rapid administration of crystalloid or colloid is unknown. We studied eight healthy male subjects in a two-part crossover trial designed to assess the maximal increase in intravascular volume ac...

OBJECTIVES Evidence to guide fluid resuscitation evidence in sepsis continues to evolve. We conducted a multicountry survey of emergency and critical care physicians to describe current stated practice and practice variation related to the quantity, rapidity and type of resuscitation fluid administered in early septic shock to inform the design of future septic shock fluid resuscitation trials....

Editors,—I read with interest the article by Ruttmann, James and Aronson1 concerning haemodilution with hydroxethyl starch and normal saline. However, I disagree with their conclusion that they have shown that haemodilution per se exerted a procoagulant effect in both groups. Instead, I propose that their conclusion should be that they demonstrated that haemodilution with normal saline resulted...

OBJECTIVE This study tested the hypothesis that cardioplegic solution supplemented with a nitric oxide donor agent attenuates postischemic cardiomyocytic apoptosis by reduction of mitochondrial complex I up-regulation during global cardiac arrest under cardiopulmonary bypass. METHODS Twenty-four anesthetized dogs supported by total vented bypass were divided evenly into 4 groups (n = 6) and s...

BACKGROUND We have shown previously that hemorrhagic hypotension is associated with a progressive development of vascular hyporeactivity to norepinephrine (NE). The present study investigated whether select crystalloid or colloid resuscitation fluids would ameliorate this effect. METHOD Anesthetized male rats were hemorrhaged to and maintained at a mean arterial pressure (MAP) of 50 mm Hg for...

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency medicine 2016. Other selected articles can be found online at http://www.biomedcentral.com/collections/annualupdate2016. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901.

BACKGROUND Severe traumatic injury and haemorrhagic shock are frequently associated with disruptions of coagulation function (such as trauma-induced coagulopathy TIC) and activation of inflammatory cascades. These pathologies may be exacerbated by current standard of care resuscitation protocols. Observational studies suggest early administration of plasma to severely-injured haemorrhaging pati...

Abstract Aim Appropriate fluid management in major burn injuries is directly related to survival rates. Despite this fact, there are still controversies regarding the choice of replacement given during resuscitation and maintenance stages acute burns. The aims study compare current paediatric prescriptions against guidelines, assess whether any adverse effects (i.e., electrolyte disturbance). M...