Which is the best fluid for resuscitation during shock state?
ANSWER: (A) CrystalloidsREF: Schwartz's Principles of Surgery 9th ed chapter 5"Fluid resuscitation is a major adjunct to physically controlling hemorrhage in patients with shock. The ideal type of fluid to be used continues to be debated; however, crystalloids continue to be the mainstay of fluid choice"Several studies have demonstrated increased risk of death in bleeding trauma patients treated with colloid compared to patients treated with crystalloid. In patients with severe hemorrhage, restoration of intravascular volume should be achieved ivith blood products.Ongoing studies continue to evaluate the use of hypertonic saline as a resuscitative adjunct in bleeding patients. The benefit of hypertonic saline solutions may be immunomodulatory. Specifically, these effects have been attributed to pharmacologic effects resulting in decreased reperfusion-mediated injury with decreased O2 radical formation, less impairment of immune function compared to standard crystalloid solution, and less brain swelling in the multi- injured patient. The reduction of total volume used for resuscitation makes this approach appealing as a resuscitation agent for combat injuries and may contribute to a decrease in the incidence of ARDS and multiple organ failure.
Crystalloids
Colloids
Plasma substitutes
5% dextrose
Shock