Using Small‐Volume Resuscitation in Sweden: Observations From Initial Experiences

Abstract

SUMMARYOne of the most striking features of infusing hypertonic solutions is the rapid onset of plasma volume expansion. Following a renewed interest raised by Brazilian researchers in 1980, various hyperosmotic solutions ‐ hypertonic saline alone or in combination with dextran or hetastarch ‐ have been developed for prehospital resuscitation of severe hemorrhagic shock. They have also been used in burns, sepsis, nontraumatic hemorrhages, and vascular and cerebral injuries. While clinical trials have not provided definitive data as to their efficacy, the available studies show that they might be beneficial in improving survival in patients with hypotension associated with traumatic injury. Furthermore, there is much clinical evidence that hypertonic solutions alone or in combination with colloids are the fluid of choice for head‐trauma patients. Numerous studies have already established their safety.