The role of isotonic and hypertonic solutions in the resuscitation of shocked patients.

The role of intravenous salt solutions in resuscitation is reviewed historically. A brief account of the pathophysiology of shock is given. The particular use of hypertonic solutions in the resuscitation of severely shocked patients is reviewed and its mechanism of action discussed. It is considered that hypertonic solutions may find a role in any future major military conflict. Two hypertonic solutions that are suggested for consideration in this context are 12% sodium chloride (2 mmol/ml) and 8.4% sodium bicarbonate (1 mmol/ml).