Fluid resuscitation for trauma patients in the 21st century

There is no consensus regarding the optimal treatment of hemorrhagic shock in trauma patients. Continued controversy exists regarding the most appropriate fluid during trauma resuscitation. Published data can be found in support of isotonic crystalloids, hypertonic solutions, colloids, and, recently, blood substitutes. None of these prospective randomized clinical studies were large enough (sufficiently powered statistically) to demonstrate a survival benefit for any particular type of volume resuscitation. Ongoing investigations in fluid resuscitation are changing our understanding of the treatment of shock. This update reviews the recent literature on fluid resuscitation in the trauma patient and speculates on future trends in this exciting field. (C) 2000 Lippincott Williams and Wilkins, Inc.