Review Note

Last Update: 06/07/2024 02:35 PM

Current Deck: SLS Cards::9. Trauma

New Card (Unpublished)

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Field Change Suggestions:
What is the best IVF to give a trauma resus patient?
NaCl
  • most commonly used, isotonic
  • large volume --> may cause hyperchloremic metabolic acidosis
  • may cause immune and kidney dysfunction; postresus interstitial sodium --> water retention
Ringer lactate and Plasma-lyte
  • relatively hypotonic, less [Na] vs ECF
  • large volume --> may vause hyperlactemia, metabolic alkalosis, hypotonicity, cardiotoxicity
  • combining Ca and RBC --> may cause microthrombi
Examples
  • Hemorrhagic shock patients --> L-isomer of Ringer lactate = less inflamation, immune dysfunction, and mortality when critically ill
  • Brain edema, TBI, massive hemorrhage --> hypertonic saline
  • Cannot tolerate large crystalloid volumes --> colloids (caution in renal impairment)