Một số trong số đó là phổ biến cho tất cả hoặc một nhóm của HBOCs, trong khi những người khác là cụ thể cho một sản phẩm. Như hiện nay, tất cả các giải pháp hemoglobin thử nghiệm sử dụng hemoglobin cao tinh khiết về mặt lý thuyết, chất nền, virus, và endotoxins không phải là một mối quan tâm | Fluid Therapy 73 Table Volume effects of fluids. Solution Intravascular volume effect of infused volume Ringer s solution 25 NaCl 25 Glucose 5 10 NaCl 300-400 6 dextran 60 120 6 HES 450 100 6 HES 200 100 10 dextran 40 200 6 HES 200 100 10 HES 200 130 6 HES 70 70 3 gelatin 70 5 albumin 70-90 6 HES 130 100 to give only a limited amount of fluid just to raise the blood pressure to a tolerable level. Then bleeding should be stopped as soon as possible after which the fluid level should be optimized. What Neither blood nor albumin are suitable liquids for fluid resuscitation leaving only synthetic fluids as an option. The discussion whether crystalloids or colloids are to be preferred seems to be a never-ending story. Both kinds of solutions increase the cardiac output appropriately if administered correctly that is with the right substitution ratio crystalloids 1 3-4 colloids 1 . To date no conclusions can be drawn whether crystalloids or colloids are preferred when only overall mortality is considered 29 . The final decision of the kind of fluid administered is determined by volume effects required Table the side effects costs etc. With the knowledge we have to date the most important thing is not whether crystalloid or colloid is used but the fact that the patient is actually volume-resuscitated. How much Hypovolemia is detrimental since it precipitates tissue hypoxia. Giving too much fluids may be just as detrimental. Hypervolemia may lead to pulmonary edema and paralytic ileus. Tissue edema can lead to tissue hypoxia as well. That is why it would be beneficial to know the optimum fluid level of any individual. Monitoring the volume status of individual patients is an art. There is no number or symptom which tells whether a patient will benefit from further volume or not. Good clinical judgment is needed to find the best possible volume level for an individual patient. As a rule of thumb it is assumed that hypovolemia .
