Hyperosmotic-hyperoncotic solutions

George Kramer, G. I. Elgjo, L. F. Poli de Figueiredo, C. E. Wade

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Since the first descriptions of the use of 7.5% hypertonic saline for resuscitation of haemorrhage in 1980, there has been substantial animal research and clinical evaluation of small volume resuscitation. Most interest has focused on combined hyperosmotic and hyperoncotic colloid formulations. Infused hyperosmotic NaCl rapidly expands plasma volume, while the hyperoncotic colloid sustains the volume expansion. Other contributing factors to the efficacy of these solutions are increased cardiac effectiveness and peripheral vasodilation. The most often studied solution, 7.5% NaCl/6% dextran 70, offers promise to reduce the mortality of traumatic hypotension and head injury when used as an initial treatment. Future hyperosmotic-hyperoncotic formulations with different solutes may provide specific beneficial pharmacological properties in addition to the established cardiovascular effects of hyperosmolarity. A particularly promising formulation might be a combination solution of an oxygen carrier colloid, for example, haemoglobin, and a hyperosmotic crystalloid.

Original languageEnglish (US)
Pages (from-to)143-161
Number of pages19
JournalBailliere's Clinical Anaesthesiology
Volume11
Issue number1
DOIs
StatePublished - 1997

Fingerprint

Colloids
Resuscitation
Plasma Volume
Dextrans
Craniocerebral Trauma
Vasodilation
Hypotension
Hemoglobins
Pharmacology
Hemorrhage
Oxygen
Mortality
Therapeutics

Keywords

  • Cardiac physiology
  • Fluid therapy
  • Hemorrhage
  • Resuscitation
  • Shock
  • Trauma
  • Volume expansion

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Kramer, G., Elgjo, G. I., Poli de Figueiredo, L. F., & Wade, C. E. (1997). Hyperosmotic-hyperoncotic solutions. Bailliere's Clinical Anaesthesiology, 11(1), 143-161. https://doi.org/10.1016/S0950-3501(97)80009-8

Hyperosmotic-hyperoncotic solutions. / Kramer, George; Elgjo, G. I.; Poli de Figueiredo, L. F.; Wade, C. E.

In: Bailliere's Clinical Anaesthesiology, Vol. 11, No. 1, 1997, p. 143-161.

Research output: Contribution to journalArticle

Kramer, G, Elgjo, GI, Poli de Figueiredo, LF & Wade, CE 1997, 'Hyperosmotic-hyperoncotic solutions', Bailliere's Clinical Anaesthesiology, vol. 11, no. 1, pp. 143-161. https://doi.org/10.1016/S0950-3501(97)80009-8
Kramer, George ; Elgjo, G. I. ; Poli de Figueiredo, L. F. ; Wade, C. E. / Hyperosmotic-hyperoncotic solutions. In: Bailliere's Clinical Anaesthesiology. 1997 ; Vol. 11, No. 1. pp. 143-161.
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