ISSN 2398-2942      

Fluid therapy: acute circulatory collapse

icanis

Causes

  • Severe hemorrhage.
  • Severe gastrointestinal disease (vomiting, diarrhea).
  • Endotoxemia.
  • Other causes of severe plasma volume loss such as hypoadrenocorticism Hypoadrenocorticism , hemorrhagic gastroenteritis (HGE) and severe burns.

Treatment

  • Aim is to restore circulating blood volume rapidly.
  • Place at least one large-bore venous catheter Cephalic catheterization.
    Jugular catheters enable fastest fluid infusion.
  • Rapid infusions of crystalloids (90 ml/kg/hour) will increase blood volume, but only about one-quarter of the volume infused will remain in the vascular space.
  • Hypertonic saline (4 ml/kg) will expand the vascular space much faster than crystalloid fluids. However, follow hypertonic saline treatment with isotonic crystalloid solution.
    For composition of solutions see parenteral fluids comparison table Parenteral fluids comparison table.Hypertonic saline also has beneficial indirect effects on the cardiovascular system.Alternatively, colloid solutions (hydroxyethyl starch, dextran Dextrans , and gelatin solutions Gelatine , and plasma or human albumin solution) may be infused rapidly and have a greater plasma volume expansion effect than crystalloids.

Further Reading

Publications

Refereed papers

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