{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T18:27:18Z","timestamp":1761676038026,"version":"3.43.0"},"reference-count":46,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J R Army Med Corps"],"published-print":{"date-parts":[[2004,12]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/jramc-150-04-03","type":"journal-article","created":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T19:43:32Z","timestamp":1363722212000},"page":"239-243","source":"Crossref","is-referenced-by-count":9,"title":["Hypertonic Saline"],"prefix":"10.1136","volume":"150","author":[{"given":"J E","family":"Smith","sequence":"first","affiliation":[{"name":"Defence Medical Services jasonsmith@doctors.org.uk"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M J","family":"Hall","sequence":"additional","affiliation":[{"name":"Surgical Rotation, Derriford Hospital Plymouth PL6 8DH United Kingdom matthall50@yahoo.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2004,12,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1097\/00003246-199901000-00053","article-title":"Crystalloids vs. colloids in fluid resuscitation: a systematic review","volume":"27","author":"Choi, P.T.; Yip, G.; Quinonez, L.G.; Cook, D.J.","year":"1999","unstructured":"Choi PT, Yip G, Quinonez LG, Cook DJ. 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A prospective, randomized, and controlled study of fluid management in children with severe head injury: lactated Ringer's solution versus hypertonic saline. Crit Care Med 1998; 26(7): 1265-70.","journal-title":"Crit Care Med; A prospective, randomized, and controlled study of fluid management in children with severe head injury: lactated Ringer's solution versus hypertonic saline"},{"issue":"10","key":"ref_24","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1001\/archsurg.1990.01410220093013","article-title":"Analysis of potential risks associated with 7.5% sodium chloride resuscitation of traumatic shock","volume":"125","author":"Vassar, M.J.; Perry, C.A.; Holcroft, J.W.","year":"1990","unstructured":"Vassar MJ, Perry CA, Holcroft JW. Analysis of potential risks associated with 7.5% sodium chloride resuscitation of traumatic shock. 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II: Volume repletion with minimal edema using the \"HALFD\" (Hypertonic Albuminated Fluid Demand) regimen","volume":"7","author":"Jelenko, C.; Wheeler, M.L.; Callaway, B.D.; Divilio, L.T.; Bucklen, K.R.; Holdredge, T.D.","year":"1978","unstructured":"Jelenko C, Wheeler ML, Callaway BD, Divilio LT, Bucklen KR, Holdredge TD. Shock and resuscitation. II: Volume repletion with minimal edema using the \"HALFD\" (Hypertonic Albuminated Fluid Demand) regimen. JACEP 1978; 7(9): 326-33.","journal-title":"JACEP"},{"issue":"2","key":"ref_33","first-page":"139","article-title":"Cardiac compliance and effects of hypertonic saline","volume":"35","author":"Croft, D.; Dion, Y.M.; Dumont, M.; Langlois, D.","year":"1992","unstructured":"Croft D, Dion YM, Dumont M, Langlois D. Cardiac compliance and effects of hypertonic saline. 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Hypertonic saline for intraoperative fluid therapy. Crit Care Med 1990; 18(4): 5193.","journal-title":"Crit Care Med"},{"issue":"1","key":"ref_37","first-page":"4151","article-title":"Hypertonic sodium lactate versus lactated ringer's solution for intravenous fluid therapy in operations on the abdominal aorta","volume":"94","author":"Shackford, SR, Sise; MJ, Fridlund; P.H.","year":"1983","unstructured":"Shackford SR, Sise MJ, Fridlund PH, et al. Hypertonic sodium lactate versus lactated ringer's solution for intravenous fluid therapy in operations on the abdominal aorta. 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