Critical reviews in clinical laboratory sciences
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Crit Rev Clin Lab Sci · Jan 1989
ReviewThe use of crystalloidal and colloidal solutions for volume replacement in hypovolemic shock.
A wide variety of colloidal and crystalloidal fluids, as well as blood and blood products, are available to the clinician for treatment of the hypovolemic patient. These fluids vary with respect to the size, shape, and concentrations of electrolytes, colloidal molecules, and/or cellular components, duration of volume-expanding effects, incidence of allergic reactions, and effect on the coagulation system. When these fluids are administered intravenously, their distribution in the vascular, interstitial, and cellular compartments can be predicted from fundamental physiological principles as well as from the results of laboratory and clinical research. ⋯ Similar volumes of crystalloidal fluids more rapidly expand the interstitial and intracellular spaces. These principles guide therapy in hypovolemic shock. A logical decision regarding intravenous fluid therapy may be based on the nature of the volume deficit (blood, plasma, or selective protein loss, loss of free water and/or electrolytes) and the predicted changes in cellular and extracellular compartments.