Abstract
The optimal kind of fluid for fluid resuscitation during acute, severe hemorrhage is still discussed controversially. Of particular interest in this context is the choice of colloids versus crystalloids and their effect on the critical hemoglobin level. In a previous issue of Critical Care, Pape and colleagues describe the effect of four different volume replacement options on the critical hemoglobin concentration, and show marked differences for the different treatments. Even though some important pathophysiological issues remain unsolved, the current manuscript adds interesting evidence to an ongoing quest.
Highlights
The optimal kind of fluid for fluid resuscitation during acute, severe hemorrhage is still discussed controversially
In light of the numerous risks associated with allogeneic blood transfusions, many efforts have been made towards blood-sparing management of the perioperative phase [2]
When the hemoglobin concentration falls below the level where oxygen delivery does not meet the tissue oxygen demand anymore, a critical hemoglobin level (Hbcrit) has been reached and outcome is poor without intervention, that is, the administration of red blood cells [3]
Summary
The optimal kind of fluid for fluid resuscitation during acute, severe hemorrhage is still discussed controversially. Pape and colleagues discuss the effect of different volume replacements in a previous issue of Critical Care [1]. Dilutional anemia, the amount of blood transfusions given throughout surgery can be reduced; an adequate oxygen supply/ demand relationship and resulting adequate tissue oxygenation are the limiting factors when applying this technique.
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