Fluid Resuscitation: State of the Science for Treating Combat Casualties and Civilian Injuries

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Fluid Resuscitation: State of the Science for Treating Combat Casualties and Civilian Injuries (1999)
Institute of Medicine (IOM)

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. "3 Experience with and Complications of Fluid Resuscitation." Fluid Resuscitation: State of the Science for Treating Combat Casualties and Civilian Injuries. Washington, DC: The National Academies Press, 1999.

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TABLE 3-1

Electrolyte Characteristics of Selected Resuscitation Fluids and Research Formulations

Fluid	Fluid Compartment	Osmolarity (mOsM/1)	pH	Na⁺ (meq/1)	Cl (meq/1)	K⁺ (meq/l)	Mg²⁺ (meq/l)	Ca²⁺ (meq/l)	Dextrose (g/l)	Buffer
Blood^a
Normal serum	Intravascular	308	7.4	140	100	4	0	0	0-4	Protein, bicarbonate
Crystalloid
0 9% Saline	Extracellular	308	5.0	154	154	0	0	0	0	None
Lactated Ringer's solution	Extracellular	275	6.5	130	109	4	0	3	0	Lactate
Plasmalyte-A, pH 7.4	Extracellular	294	7.4	140	98	5	3	0	0	Acetate, gluconate
Normosol-R	Extracellular	295	55-7.0	140	98	5	3	0	0	Acetate, gluconate
7.0% Sahne	Extracellular	2,396		1,197	1,197	0	0	0	0	None
5% Dextrose m water	Extracellular	252	4.0	0	0	0	0	0	50	None
Colloid
Natural
5% Albumin	Intravascular	309	6.4-7.4	130-160	130-160		0	0		Sodium bicarbonate, sodium hydroxide, or acetic acid
25% Albumin	Intravascular	312	6.4-7.4	130-160	130-160		0	0		Sodium bicarbonate, sodium hydroxide, or acetic acid
Frozen plasma	Intravascular	300	Variable	140	110	4	0	0	0-4	Protein, bicarbonate
Synthetic
6% Hetastarch	Intravascular	310	5.5	154	154	0	0	0	0	None
10% Pentastarch	Intravascular	326	5.0	154	154	0	0	0	0	None
Dextran 40	Intravascular	311	3.5-7.0	154	154	0	0	0	0	None
Dextran 70	Intravascular	310	3.0-7.0	154	154	0	0	0	0	None
Oxypolygelatin	Intravascular	200	7.4	155	100	0	0	1	0	None
Research Formulations
Carolina Rinse^b		290-305	6.5	115	122	6	1.2	1.3	1.8	MOPS
Wisconsin Solution^c	Intravascular	320	7.4	25	0	125	5	0	0	Potassium phosphate
Veech's Fluid		294.3	7	136	106	4	1	2	5	Bicarbonate
^a Included as a point of comparison ^b Contains hydroxyethyl starch (50 grams/liter), allopurinol (1 millimolar [mM]), desferrioxamine (1 mM), glutathione (3 mM), fructose (10 mM), glucose (10 mM), adenosme (200 micromolar [µM]), nicardipine (2 µM), insulin (100 U/liter), 3-[N]-morpholinopropanesulfonic acid (20 mM), and glycine (5 mM) ^c Contains hydroxyethyl starch (50 grams/liter), benisine (5 mM), glutathione (3 mM), allopurinol (1 mM), insulin, penicillin, and dexamethesone SOURCE Adapted from Lemasters et al. (1995), Physicians' Desk Reference (1999), Rudloff and Kirby (1998), and Veech (1986)