RETRACTED: II. The balanced concept of fluid resuscitation

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Abstract
In trauma, burn, surgical, and intensive care patients with hypovolaemia, adequate volume restoration is essential to avoid development of organ failure. This manoeuvre is aimed at guaranteeing stable macro- and micro-haemodynamics while avoiding excessive interstitial fluid overload. The choice of fluid engenders much controversy and there is considerable dispute over the pros and cons of each type. Most crystalloids consist of a non-physiological mixture of electrolytes.1 In the beginning of the 1990s, substantial alterations in acid–base status were described in patients who had large amounts of saline (NS) infused.2 This has been defined as ‘hyperchloraemic acidosis’.3 Colloids have been shown to be more effective than crystalloids for correcting intravascular volume deficits and for improving systemic and microcirculatory haemodynamics.4,5 Consequently, colloids are often preferred for correcting hypovolaemia.6 Almost all colloids [albumin, hydroxyethylstarch (HES), gelatins] are prepared in non-physiological solutions and can be defined as ‘unbalanced colloids’. The use of large amounts of these colloids may be associated with unwanted electrolyte or acid–base disturbances. Our emerging understanding of the (patho-) physiology of the different volume replacement strategies leads to the question as to why infusion solutions are so poorly compounded.

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