Crystalloid, colloid or small volume resuscitation?

Small volume resuscitation fluids are a combination of hypertonic crystalloid with a colloid. SVR fluids have the advantage of logistical convenience in the field situation. Clinical trials point to improved outcome in patients with penetrating trauma injury or traumatic brain injury. HSD may reduce the inflammatory process and has shown improved outcome in trauma patients who require intensive care. Trials so far have been carried out in small numbers of patients and improved survival benefit has only become evident on meta-analysis and sub-group analysis. Further large scale blinded randomized trials are required to confirm the promise of survival advantages.