Small-volume resuscitation. Crystalloid solutions for intravascular volume replacement.

There is growing interest in the use of hypertonic crystalloid solutions for intravascular volume replacement. Such solutions rapidly restore nutrient blood flow to vital organs by a combination of increased perfusion pressure and vascular dilation. The addition of colloid to the solution appears to improve survival by limiting the tissue damage caused by ischemic injury and may avert the development of multisystem organ failure. Low cost and long shelf life make hypertonic solutions attractive for acute resuscitation after major trauma, but further investigations are warranted as to their efficacy and safety in the clinical setting.