Solutions for volume resuscitation in trauma patients

Resuscitation of patients in hemorrhagic shock remains one of the most challenging aspects of trauma care. Controversy persists regarding the most appropriate type, timing, and volume of resuscitation of trauma victims. Published data can be found in support of isotonic crystalloids, hypertonic solutions, and colloids. However, very few prospective clinical studies have been conducted, and these trials fail to demonstrate a survival benefit favoring a particular mode of volume resuscitation. The recent development of safe, oxygen-carrying blood substitutes may offer yet another alternative in the management of these patients. This article reviews the recent literature on fluid resuscitation in the trauma patient.