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The effective management of critically ill patients should be a continuum stretching from the prehospital environment through the emergency department to the critical care unit. Fluid resuscitation to increase circulating volume is a core part of acute care to treat hypovolaemia, hypotension and shock. It has formed a key component of campaigns to improve patient outcomes.1
Traditionally the fluid administered has been a crystalloid (0.9% saline or a ‘balanced’ fluid eg, Hartmann's solution), synthetic colloid (hydroxyethylstarch (HES) or gelatin) or rarely human albumin solution. Use of colloids varies across the world, starches are more common in Continental Europe, …
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