Hypertonic versus near isotonic crystalloid for fluid resuscitation in critically ill patients

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This review does not give us enough data to be able to say whether hypertonic crystalloid is better than isotonic and near isotonic crystalloid for the resuscitation of patients with trauma or burns, or those undergoing surgery. However, the confidence intervals are wide and do not exclude clinically significant differences.

Hypertonic solutions are considered to have a greater ability to expand blood volume and thus elevate blood pressure, and can be administered as a small volume infusion over a short time period. On the other hand, the use of hypertonic solutions for volume replacement may also have important disadvantages. This review evaluates whether hypertonic crystalloid decreases mortality in patients with hypovolaemia.

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