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Titolo:
Fluid replacement
Autore:
Nolan, J;
Indirizzi:
Royal United Hosp, Dept Anaesthesia, Bath BA1 3NG, Avon, England Royal United Hosp Bath Avon England BA1 3NG , Bath BA1 3NG, Avon, England
Titolo Testata:
BRITISH MEDICAL BULLETIN
fascicolo: 4, volume: 55, anno: 1999,
pagine: 821 - 843
SICI:
0007-1420(1999)55:4<821:FR>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
WEIGHT HYDROXYETHYL STARCH; COLLOID OSMOTIC-PRESSURE; CRITICALLY ILL PATIENTS; RANDOMIZED TRIAL; GASTROINTESTINAL TONOMETRY; ANAPHYLACTOID REACTIONS; OXYGEN-CONSUMPTION; PLASMA SUBSTITUTES; HEMORRHAGIC-SHOCK; INJURED PATIENTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
75
Recensione:
Indirizzi per estratti:
Indirizzo: Nolan, J Royal United Hosp, Dept Anaesthesia, Combe Pk, Bath BA1 3NG, Avon, England Royal United Hosp Combe Pk Bath Avon England BA1 3NG von, England
Citazione:
J. Nolan, "Fluid replacement", BR MED B, 55(4), 1999, pp. 821-843

Abstract

Appropriate fluid replacement is an essential component of trauma patient resuscitation. Once haemorrhage is controlled, the restoration of normovolaemia is a priority. In the presence of uncontrolled haemorrhage, aggressivefluid resuscitation may be harmful. The crystalloid-colloid debate continues, but existing clinical practice is more likely to reflect local biases and dogma rather than evidence-based medicine. Colloids vary substantially in their pharmacology and pharmacokinetics and the experimental findings based on one colloid cannot be extrapolated reliably to another. in the initial stages of trauma patient resuscitation, the precise fluid used is probably not important, as long as an appropriate volume is given. Later, when themicrocirculation is relatively leaky, there may be some advantages to colloids such as hydroxyethyl starch. Hypertonic saline solutions may have somebenefit in patients with head injuries. A number of haemoglobin solutions are under development but one of the most promising of these has been withdrawn recently. It is highly likely that at least one of these solutions will eventually become routine therapy for trauma patient resuscitation. In the mean time, contrary to traditional teaching, recent data suggest that a restrictive strategy of red cell transfusion may improve outcome in some critically ill patients.

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Documento generato il 23/01/21 alle ore 01:45:31