Prehospital Fluid Replacement

  • U. Kreimeier
  • K. Peter
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1997)

Abstract

Volume support is frequently required in critically ill patients exhibiting hypovolemia due to severe trauma, hemorrhage, or sepsis. Primary resuscitation from hemorrhagic shock calls for rapid infusion of crystalloids in combination with artificial colloids, whereas albumin or blood components are restricted to clinical use [1]. In the past years, a great body of experimental and clinical studies have been performed to explore the efficacy and safety of artificial colloids, i.e. gelatin, dextran and hydroxyethylstarch. New formulations of hydroxyethylstarch have been designed to optimize the volume effect, metabolism and thus half-life. In addition, a new concept called “small-volume resuscitation”, consisting of bolus infusion of a small dose of hyperosmotic-hyperoncotic sodium chloride, has been introduced for primary fluid therapy, and is presently investigated in several controlled clinical trials. The following review summarizes the current status of fluid therapy for primary resuscitation of critically ill trauma patients.

Keywords

Starch Hepatitis Depression Ischemia Attenuation 

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© Springer-Verlag Berlin Heidelberg 1997

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  • U. Kreimeier
  • K. Peter

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