Are hypertonic hyperoncotic solutions safe for prehospital small-volume resuscitation? Results of a prospective observational study

RATIONALEThis prospective observational study was designed to shed light on the routine use of a hypertonic hyperoncotic solution for prehospital small-volume resuscitation in trauma patients. Effects on homeostasis and haemodynamics as well as safety were evaluated. METHODSOne hundred patients with haemorrhagic shock were given hypertonic hyperoncotic solution (6% hydroxyethyl starch plus 7.5% sodium chloride) by bolus infusion (approximately 4 ml/kg bodyweight). Blood was taken before small-volume resuscitation and after the patientsʼ arrival in the emergency room and serum electrolytes, haemoglobin, haematocrit, colloid osmotic pressure and white cell counts were determined. Haemodynamic variables were evaluated before small-volume resuscitation, just before transport and on arrival. RESULTSSerum sodium and serum chloride increased at best moderately between baseline and arrival (7 and 12 mmol/l, medians; P