What type of fluids do patients in hypovolemic shock need?

What type of fluids do patients in hypovolemic shock need?

• A. Isotonic solutions like normal saline or lactated Ringer's
• B. Hypotonic saline
• C. Hypertonic saline
• D. Dextrose solutions

Answer: (A)

In hypovolemic shock the main issue is a loss of circulating blood volume, so the goal is to quickly restore intravascular volume to improve preload and tissue perfusion. Isotonic crystalloids, like normal saline or lactated Ringer’s, have about the same osmolarity as blood. Because of this, they expand the vascular space without causing water to shift into cells or draw water out of the vessels. They reliably increase circulating volume fast, making them the best first choice for resuscitation. Hypotonic fluids would pull water into cells, which can further decrease the intravascular volume. Hypertonic saline can draw water from interstitial and intracellular compartments into the vessels, but it causes rapid fluid and electrolyte shifts and is not routinely used as initial therapy for hypovolemic shock. Dextrose solutions, once the glucose is metabolized, act effectively as hypotonic and don’t provide sustained intravascular volume expansion, plus they may cause undesirable metabolic effects.

In hypovolemic shock the main issue is a loss of circulating blood volume, so the goal is to quickly restore intravascular volume to improve preload and tissue perfusion. Isotonic crystalloids, like normal saline or lactated Ringer’s, have about the same osmolarity as blood. Because of this, they expand the vascular space without causing water to shift into cells or draw water out of the vessels. They reliably increase circulating volume fast, making them the best first choice for resuscitation.

Hypotonic fluids would pull water into cells, which can further decrease the intravascular volume. Hypertonic saline can draw water from interstitial and intracellular compartments into the vessels, but it causes rapid fluid and electrolyte shifts and is not routinely used as initial therapy for hypovolemic shock. Dextrose solutions, once the glucose is metabolized, act effectively as hypotonic and don’t provide sustained intravascular volume expansion, plus they may cause undesirable metabolic effects.