To the Editor.—In their recent article (Arch Surg 108:531, 1974), Ledgerwood and Lucas successfully documented a "postresuscitation hypertension" caused by the administration of large volumes of isotonic sodium solutions during resuscitation from trauma and the continued large positive balances of salt and water in the days following operation. With this conclusion and their proposed therapy of salt and water limitation plus pharmacologic diuresis, none can argue. The authors fail, however, to be completely persuasive in their premise that these large volumes of salt and water are really required in the first place.
The work of Carey et al from Vietnam, quoted by the authors to support their thesis, on critical reading demonstrates only that patients can be resuscitated using large volumes of saline, not that they must be or even that it is necessarily better. The original work quoted of Shires et al using sodium sulfate S 35 and