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Invited Critique
February 1, 2008

Hypertonic Resuscitation of Hypovolemic Shock After Blunt Trauma—Invited Critique

Arch Surg. 2008;143(2):149. doi:10.1001/archsurg.2007.42

Traditionally we have thought of fluid resuscitation being aimed at restoring intravascular volume and repletion of the “third-space” fluid shifts that occur after shock or trauma. The colloid-crystalloid debate over the past 30 years has focused on these end points in determining which fluid type is better. While these arguments are relevant immediately after injury when death is due to exsanguination, more recent data have shifted our focus to using early fluid resuscitation as a way to modify the inflammatory response that leads to multiple organ failure and late death.

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