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British Journal of Anaesthesia 2007 99(3):312-315; doi:10.1093/bja/aem219
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

II. The balanced concept of fluid resuscitation

The first 150 words of the full text of this article appear below.

In trauma, burn, surgical, and intensive care patients with hypovolaemia, adequate volume restoration is essential to avoid development of organ failure. This manoeuvre is aimed at guaranteeing stable macro- and micro-haemodynamics while avoiding excessive interstitial fluid overload. The choice of fluid engenders much controversy and there is considerable dispute over the pros and cons of each type. Most crystalloids consist of a non-physiological mixture of electrolytes.1 In the beginning of the 1990s, substantial alterations in acid–base status were described in patients who had large amounts of saline (NS) infused.2 This has been defined as ‘hyperchloraemic acidosis’.3 Colloids have been shown to be more effective than crystalloids for correcting intravascular volume deficits and for improving systemic and microcirculatory haemodynamics.4 5 Consequently, colloids are often preferred for correcting hypovolaemia.6 Almost all colloids [albumin, hydroxyethylstarch (HES), gelatins] are prepared in non-physiological solutions and can be defined as ‘unbalanced colloids’. The use of large amounts . . . [Full Text of this Article]

Benefit of avoiding hyperchloraemia: data from animal studies

Benefit of avoiding hyperchloraemia: data from volunteers/patients

New approach of fluid resuscitation: the total balanced concept

Importance of a total balanced volume replacement concept

Conclusions

Declaration of interest

J. Boldt*

Department of Anaesthesiology
and Intensive Care Medicine
Klinikum der Stadt
Ludwigshafen
Bremserstr. 79
D-67063 Ludwigshafen
Germany

* E-mail: boldtj@gmx.net


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E-letters:

Read all E-letters

How useful is balanced fluid?
Martin F Mayall
British Journal of Anaesthesia, 20 Nov 2007 [Full text]
Response to DR. Mayall`s comments
Joachim Boldt
British Journal of Anaesthesia, 3 Dec 2007 [Full text]