Shock: Fluid therapy remains a basic tenet for successful resuscitation - DVM
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Shock: Fluid therapy remains a basic tenet for successful resuscitation


DVM360 MAGAZINE


The use of self-assembling amphophilic lipids or liposomes has been studied experimentally. Liposomes-encapsulated hemoglobin and red blood-cell enzymes such as superoxide dismutase are underway. The physiology and toxicity profiles thus far suggest that further research is needed before these products can be safely recommended.

The concept of freeze-drying blood products is not new but has led to continued investigations. Freeze-dried plasma products maintain undamaged protein constituents, even after 10 years of storage in a freeze-dried stage. The powder can be quickly reconstituted and even dissolved in a small volume of solvent that would yield a hyperoncotic, hypertonic fluid. Freeze-dried plasma might prove to be a method of resuscitation that prevents immune overactivation and allows for an easily stored, rapidly reconstituted resuscitation fluid of the future.

Conclusions

There is still ample room for research investigating the role of fluid type, quantity and fluid additives for resuscitation of animals with cardiovascular shock. The type of shock and stage of shock (compensatory, early decompensatory or late decompensatory) plays a major role in the approach to treatment.

The inflammatory response following hemorrhage is not the same as the inflammatory response following septic shock, so trying to use the same resuscitation strategy could prove fruitless.

The decision to use one class of fluid over another should be subjected to the same critical thought process and dependence on scientific evidence that takes place when choosing a drug to administer to a patient. Recent meta-analyses are beneficial but have not settled the debate and are fraught with their own weaknesses.

There is no "magic bullet" intravenous fluid solution for all patients with shock.

Dr. Hoskins is owner of DocuTech Services. He is a diplomate of the American College of Veterinary Internal Medicine with specialities in small animal pediatrics. He can be reached at (225) 955-3252, fax: (214) 242-2200, or e-mail:
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Source: DVM360 MAGAZINE,
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