Which fluid type is preferred for resuscitation in crush injuries according to the protocol?

Which fluid type is preferred for resuscitation in crush injuries according to the protocol?

• A. Normal Saline
• B. Lactated Ringer's
• C. Hypertonic saline
• D. Dextrose 5% in water

Answer: (A)

In crush injuries, the priority is rapid, generous IV fluid resuscitation to restore circulating volume and keep kidneys filtering, reducing the risk of myoglobin-related kidney injury. Normal saline is the fluid of choice for this purpose because it provides immediate isotonic volume expansion without adding lactate or calcium that could complicate the patient’s acid-base balance and electrolyte status. Lactated Ringer’s also acts as an isotonic solution, but its lactate component can complicate lactic acidosis in extensive tissue injury, and calcium in LR can pose additional electrolyte challenges during rhabdomyolysis. Hypertonic saline is not used for routine resuscitation in crush injuries because it can cause rapid shifts in fluids and electrolytes, increasing risk of complications. Dextrose-containing solutions don’t provide reliable volume expansion and can elevate blood glucose, which isn’t helpful in the acute resuscitation phase. So, normal saline best supports the goal of maintaining perfusion and renal clearance in crush injuries.

In crush injuries, the priority is rapid, generous IV fluid resuscitation to restore circulating volume and keep kidneys filtering, reducing the risk of myoglobin-related kidney injury. Normal saline is the fluid of choice for this purpose because it provides immediate isotonic volume expansion without adding lactate or calcium that could complicate the patient’s acid-base balance and electrolyte status.

Lactated Ringer’s also acts as an isotonic solution, but its lactate component can complicate lactic acidosis in extensive tissue injury, and calcium in LR can pose additional electrolyte challenges during rhabdomyolysis. Hypertonic saline is not used for routine resuscitation in crush injuries because it can cause rapid shifts in fluids and electrolytes, increasing risk of complications. Dextrose-containing solutions don’t provide reliable volume expansion and can elevate blood glucose, which isn’t helpful in the acute resuscitation phase.

So, normal saline best supports the goal of maintaining perfusion and renal clearance in crush injuries.