Volume replacement is the most important step in treating hypovolaemic shock.
Blood is needed when the oxygen carrying capacity threatens to fall below a critical level, but has the disadvantage of transmitting virus hepatitis. Anicteric hepatitis is about four times more frequent than the icteric form. Pasteurized plasma protein solution and albumin are free from the risk of transmitting hepatitis virus, and are good volume restorers.
Dextran 70 represents the best artificial colloid with additional anti-thrombotic properties. Dextran 40 is indicated in special situations to promote flow.
There is no proof that large amounts of Ringer solution are superior for treating hypovolaemic shock in man compared with colloids and electrolytes.
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