Which is the best initial fluid for resuscitation during the shock state
Crystalloids predominantly expand the interstitial and then the intracellular compament not the intravascular compament (expansion of intravascular compament is only transient). This is necessary to replenish the intracellular and interstitial compament as in a hypovolemic patient, the shock induced homeostasis has already shifted the intracellular and interstitial fluid into the vascular compament. Colloids on the other hand cause expansion of the vascular compament; colloids imbibe fluid from the interstitial and intracellular compament thus fuher compromising the already depleted intracellular compament. Hence crystalloids are the initial fluid of choice. Examples of Crystalloids: Ringer lactate (most commonly used crystalloid), Normal saline, 5 % Dextrose, Isolyte Examples of Colloids: Albumins, Dextrans, Hydroxyethyl starches(HES), Gelatins
Crystalloids
Colloids
Blood
Plasma substitutes
General surgery