Oral Therapy

Abstract

The simplest method for volume replacement is certainly oral administration of hypotonic saline solution. Isotonic saline solutions would be desirable, but they can usually not be swallowed by the patients due to the unappetizing taste. The p. o. therapy, however, is suitable only for the treatment of smaller volume losses (up to 30% of the BV at most) or as an additional measure when i. v. replacement is incomplete. It seems appropriate to support the spontaneous refilling of the vascular system by such a procedure. After multiple injuries patients are often incapable of taking fluid orally (unconsciousness!) and therapy of this kind should only be started if one is certain that there is no injury to the gastrointestinal tract and that therapy can be started immediately after the volume loss. A risk does exist in that patients who may receive such treatment often have a tendency to vomit and thus are subjected to the danger of aspiration. From the standpoint of the anesthesiologist as well, this procedure is undesirable if there is to be anesthesia and surgery shortly after the treatment for shock.