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Hypertonic Saline
  1. Surg Lt Cdr J E Smith, MBBS MSc MRCP FFAEM RN, Specialist Registrar in Emergency Medicine1 and
  2. M J Hall, BSc (Hons) MBChB, Senior House Officer2
  1. 1Defence Medical Services jasonsmith{at}
  2. 2Surgical Rotation, Derriford Hospital Plymouth PL6 8DH United Kingdom matthall50{at}


The optimal fluid for the resuscitation of critically ill and injured patients remains the subject of considerable controversy. Hypertonic crystalloid solutions such as hypertonic saline provide rapid volume expansion, have an acceptable safety profile, and are easy to store and transport. Recent meta-analyses suggest a trend toward increased survival in patients given hypertonic saline, and it has been suggested that they may have particular benefit in certain groups of patients such as hypovolaemic head injury patients. This short review examines the physiological and experimental evidence supporting the use of hypertonic saline in fluid resuscitation.

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