Resuscitation fluids

Resuscitative fluids administered for blood losses and other volume losses have been administered since the 15th century to trauma and other patients. The complex physiology of the body′s various compartments, the responses from the cardiac, respiratory, and renal systems, and even the discovery of the circulation by William Harvey and the pulmonary circulation by Miguel Servet were eventually elucidated and incorporated in the science of resuscitative fluid replacement. Wars have always provided surgeons with challenges and opportunities to investigate surgical sciences. World War I and the most recent military campaigns have allowed surgeons to evolve concepts of volume replacements. Complications of fluid replacement have resulted in the development of ARDS as well as coagulopathies. The administration, first of plasma and blood, have taken interesting and circumvoluted paths, culminating in the return to whole blood as the most important component for trauma patients and war wounded along with possible bone marrow suppression of blood administration.