Advertisment Fosfocin
Indian Journal of Critical Care Medicine
An open access publication of ISCCM™ 
 
Users online: 366 
     Home | Login 
  About Current Issue Archive Search Instructions Online Submission Subscribe Etcetera Contact  
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed25307    
    Printed417    
    Emailed13    
    PDF Downloaded1889    
    Comments [Add]    

Recommend this journal

 

 REVIEW ARTICLE
Year : 2006  |  Volume : 10  |  Issue : 4  |  Page : 241--249

Fluid resuscitation in trauma


1 Consultant Anaesthesiologists at Apollo Gleneagles Hospital, Kolkata, India
2 Medical College and Hospital, Kolkata, India

Correspondence Address:
A Rudra
1, Shibnarayan Das Lane, Kolkata - 700 006
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-5229.29843

Rights and Permissions

Appropriate fluid replacement is an essential component of trauma fluid resuscitation. Once hemorrhage is controlled, restoration of normovolemia is a priority. In the presence of uncontrolled haemorrhage, aggressive fluid management may be harmful. The crystalloid-colloid debate continues but existing clinical practice is more likely to reflect local biases rather than evidence based medicine. Colloids vary substantially in their pharmacology and pharmacokinetics,and the experimental finding based on one colloid cannot be extrapolated reliably to another. In the initial stages of trauma resuscitation the precise fluid used is probably not important as long as an appropriate volume is given. Later, when the microcirculation is 'leaky', there may be some advantages to high or medium weight colloids such as hydroxyethyl starch. Hypertonic saline solutions may have some benefit in patients with head injuries. A number of hemoglobin solutions are under development, but one of the most promising of these has been withdrawn recently. It is highly likely that at least one of these solutions will eventually become routine therapy for trauma patient resuscitation. In the meantime, contrary to traditional teaching, recent data suggest that restrictive strategy of red cell transfusion may improve outcome in some critically ill patients.






[FULL TEXT] [PDF]*


        
Print this article     Email this article

Online since 7th April '04
Published by Wolters Kluwer - Medknow