Key messages

• An adequate circulating volume must be provided before considering other methods of circulatory support.

• The use of fluid to restore circulating volume overcomes many of the problems associated with inotropes in the hypovolemic patient.

• Smaller volumes of colloid than crystalloid are required for resuscitation with less contribution to edema.

• The volume required for correction of hypovolemia is determined by the hemodynamic effect of small aliquots of plasma substitute.

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