Critical care clinics
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Early recognition of hemodynamic instability in the pediatric patient, followed by prompt intervention, is the key to successful resuscitation. Fluid management for patients in shock must be adjusted according to the patient's age and size and the pathophysiology of the underlying condition. The identification, evaluation, and fluid therapy for children presenting with shock are reviewed.
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Fluid resuscitation from traumatic hemorrhagic shock is a critical component of therapy for the critically injured patient. Therapy is aimed at restoring hemodynamic stability and oxygen delivery to tissues. ⋯ Complications of fluid therapy, especially edema, may be related to the choice of fluid infused. Identification of hypovolemia and methods to monitor tissue are important aspects of patient care.
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Critical care clinics · Apr 1992
Review Comparative StudyFluid resuscitation in patients with increased vascular permeability.
Fluid therapy is a uniformly accepted, logical, and highly effective therapeutic intervention for the treatment of patients with reductions in circulating intravascular volume. This article discusses fluid resuscitation of shock associated with increased vascular permeability and addresses the use of colloids and crystalloids in these disorders.
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We have attempted to review body fluid distribution by compartments so that the reader understands the physiology of ICF and ECF, and the relationship between interstitial and intravascular fluids. Crystalloids such as NS and RL are distributed to the ECF, whereas colloids primarily remain intravascular for longer periods. ⋯ Albumin, hetastarch, dextran, and the less commonly used colloids each have significant toxicities that must be considered when using them. Intelligent choices can be made to optimize use of these fluids.
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This article briefly reviews the pathophysiology of burn wounds as a basis for a more detailed discussion on the resuscitation of burn patients with lactated Ringer's solution or other regimens. The complications resulting from such resuscitation are also reviewed.