Can too much sodium be good for you?

Effect of isotonic versus hypotonic maintenance fluid therapy on urine output, fluid balance, and electrolyte homeostasis: a crossover study in fasting adult volunteers N. Van Regenmortel, T. De Weerdt, A. H. Van Craenenbroeck, E. Roelant, W. Verbrugghe, K. Dams, M. L. N.G. Malbrain, T. Van den Wyngaert, P. G. Jorens Br J Anaesth aex118. DOI: https://doi.org/10.1093/bja/aex118 Published:16 May 2017

Plasma and Vitamin C for shock resuscitation.

While it is easy to make the steady-state Starling case against colloids for resuscitation from hypovolaemia,  the argument from microvascular flow preservation keeps alive a possible indication for plasma infusions. The endothelial glycocalyx (EG) disintegrates after severe hemorrhagic shock, and there is laboratory evidence that plasma  could preserve or restore capillary integrity.

Low volume resuscitation – PEGged?

Really grateful to the correspondent who pointed me to interesting work being done on “cell impermeants” at Virginia Commonwealth University using the hydrogel PEG-20k. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476060/ http://journals.lww.com/jtrauma/Abstract/publishahead/Low_Volume_Resuscitation_Using_Polyethylene.99474.aspx I was previously unaware of the therapeutic potential for polyethylene glycol and remain uncertain about the “cell impermeant” rationale. Low volume hypertonic and/ or