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Module 5: Abdominal Injuries

Segment 7: Reversing Fluid Deficits

References labeled PEDS contain a pediatric element or primary focus.

Topic: Reversing fluid deficits

  • Antequera Martín AM, Barea Mendoza JA, Muriel A, et al. Buffered solutions versus 0.9% saline for resuscitation in critically ill adults and children. Cochrane Database Syst Rev. 2019;7(7):Cd012247. doi: 10.1002/14651858.CD012247.pub2 https://pubmed.ncbi.nlm.nih.gov/31334842/. PEDS
  • Arabi YM, Belley-Cote E, Carsetti A, et al. European Society of Intensive Care Medicine clinical practice guideline on fluid therapy in adult critically ill patients. Part 1: the choice of resuscitation fluids. Intensive Care Med. 2024;50(6):813-831. doi: 10.1007/s00134-024-07369-9 https://pubmed.ncbi.nlm.nih.gov/38771364/.
  • Boer C, Bossers SM, Koning NJ. Choice of fluid type: physiological concepts and perioperative indications. Br J Anaesth. 2018;120(2):384-396. doi: 10.1016/j.bja.2017.10.02 https://pubmed.ncbi.nlm.nih.gov/29406187/.
  • Broadhurst D, Cooke M, Sriram D, et al. Subcutaneous hydration and medications infusions (effectiveness, safety, acceptability): A systematic review of systematic reviews. PLoS One. 2020;15(8):e0237572. doi: 10.1371/journal.pone.0237572 https://pubmed.ncbi.nlm.nih.gov/32833979/.
  • Dhillon NK, Kwon J, Coimbra R. Fluid resuscitation in trauma: What you need to know. J Trauma Acute Care Surg. 2025;98(1):20-29. doi: 10.1097/ta.0000000000004456 https://pubmed.ncbi.nlm.nih.gov/39213260/.
  • Diz JC, Luna-Rojas P, Díaz-Vidal P, et al. Effect of treatment with balanced crystalloids versus normal saline on the mortality of critically ill patients with and without traumatic brain injury: A systematic review and meta-analysis. Anesth Analg. 2025;doi: 10.1213/ane.0000000000007368 https://pubmed.ncbi.nlm.nih.gov/39832223/.
  • Dormann J, Dahms K, Steinfeld E, et al. Crystalloid vs colloid fluid resuscitation in polytrauma patients: a systematic review. Eur J Trauma Emerg Surg. 2025;51(1):271. doi: 10.1007/s00068-025-02921-8 https://pubmed.ncbi.nlm.nih.gov/40788415/.
  • Eraky AM, Mokhtar Y, Khan A, et al. The physiology, pathophysiology, and clinical implications of fluid resuscitation in critically ill patients. Cureus. 2026;18(3):e104736. doi: 10.7759/cureus.104736 https://pubmed.ncbi.nlm.nih.gov/41943762/.
  • Hahn RG. Where does the fluid go? Ann Intensive Care. 2025;15(1):156. doi: 10.1186/s13613-025-01579-0 https://pubmed.ncbi.nlm.nih.gov/41085930/.
  • Markl-Le-Lev EA, Haller I, Bachler M. Fluid management in hemorrhagic shock. Curr Opin Anaesthesiol. 2025;doi: 10.1097/aco.0000000000001481 https://pubmed.ncbi.nlm.nih.gov/40071984/.
  • McIntyre L, Fergusson D, McArdle T, et al. A crossover trial of hospital-wide lactated Ringer’s solution versus normal saline. N Engl J Med. 2025;doi: 10.1056/NEJMoa2416761 https://pubmed.ncbi.nlm.nih.gov/40503714/.
  • Mekontso Dessap A, AlShamsi F, Belletti A, et al. European Society of Intensive Care Medicine (ESICM) 2025 clinical practice guideline on fluid therapy in adult critically ill patients: part 2-the volume of resuscitation fluids. Intensive Care Med. 2025;51(3):461-477. doi: 10.1007/s00134-025-07840-1 https://pubmed.ncbi.nlm.nih.gov/40163133/.
  • Nordstrom NK, Smida T, Bardes JM, et al. A contemporary analysis of prehospital crystalloid resuscitation after trauma. Injury. 2025;doi: 10.1016/j.injury.2025.112614 https://pubmed.ncbi.nlm.nih.gov/40683802/.
  • Pescatore RMID. In Focus: Saline is far from normal. Emerg Med News. 2023;45(4):8-9. doi: 10.1097/01.EEM.0000927184.07972.19 https://journals.lww.com/em-news/pages/articleviewer.aspx?year=2023&issue=04000&article=00003&type=Fulltext.
  • Qian ET, Brown RM, Jackson KE, et al. Normosol-R vs lactated Ringer’s in the critically ill: A randomized trial. Chest. 2025;doi: 10.1016/j.chest.2025.02.008 https://pubmed.ncbi.nlm.nih.gov/39971001/.
  • Ripollés-Melchor J, Espinosa Á V, Malbrain M, et al. Balanced crystalloids versus saline and mortality in hospitalized patients: a hierarchical Bayesian meta-analysis of cluster-randomized trials. J Crit Care. 2026;95:155665. doi: 10.1016/j.jcrc.2026.155665 https://pubmed.ncbi.nlm.nih.gov/42361768/.
  • Schortgen F, Tabra Osorio C, Carpentier D, et al. Fluid intake in critically ill patients: The “Save Useless Fluids for Intensive Resuscitation” multicenter prospective cohort study. Crit Care Med. 2024;52(2):258-267. doi: 10.1097/ccm.0000000000006091 https://pubmed.ncbi.nlm.nih.gov/37909832/.
  • Shaw JF, Ouyang Y, Fergusson DA, et al. A hospital-wide open-label cluster crossover pragmatic comparative effectiveness randomized trial comparing normal saline to Ringer’s lactate: Protocol and statistical analysis plan of the FLUID trial. JMIR Res Protoc. 2023;12:e51783. doi: 10.2196/51783 https://pubmed.ncbi.nlm.nih.gov/37801356/.
  • Smith L. Choosing between colloids and crystalloids for IV infusion. Nurs Times. 2017;113(12):20-23. 20 NOVEMBER, 2017. doi: Accessed 2022. https://www.nursingtimes.net/clinical-archive/critical-care/choosing-between-colloids-and-crystalloids-for-iv-infusion-20-11-2017/
  • Swenson ER. Balanced crystalloid versus saline solution in critically ill patients: Is chloride the villain? Am J Respir Crit Care Med. 2019;200(3):398. doi: 10.1164/rccm.201904-0806LE https://pubmed.ncbi.nlm.nih.gov/31042048/.
  • Zaki HA, Elmelliti H, Shaban A, et al. Balanced crystalloids versus normal saline for trauma resuscitation: A systematic review and meta-analysis. Am J Emerg Med. 2026;101:84-91. doi: 10.1016/j.ajem.2025.12.030 https://pubmed.ncbi.nlm.nih.gov/41475037/.