Choice of fluid

The aim of a fluid challenge is to produce a significant (200ml) and rapid increase in plasma volume. Colloid fluids are ideal; a gelatin solution is recommended for short term plasma volume expansion in simple hypovolaemia, and hydroxyethyl starch where there is a probability of capillary leak. Packed red cells have a high haematocrit and do not adequately expand the plasma volume. Crystalloid fluids are rapidly lost from the circulation and do not give a reliable increase in plasma volume.

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