Continuing Education in Anaesthesia, Critical Care & Pain | Volume 6 Number 2 2006 © The Board of Management and Trustees of the British Journal of Anaesthesia [2006]. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
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The purpose of this section of CEACCP is to provide a forum for debate and clarification of any controversies arising from previous articles.
The two recent related articles by David Counsell and Sahir Rassam on Perioperative fluid and electrolyte balance (CEACCP 2005; 5,5: 157–60) and Perioperative fluid therapy (CEACCP 2005; 5,5: 161–5) generated correspondence from Richard Seigne of Exeter and Richard Griffiths and Philip Hunt of Peterborough. Dr Seigne pointed out that ‘about one-third of patients will not demonstrate a tachycardia in the face of acute haemorrhage. 1 The authors also seem to imply that the state of hydration and a patient's intravascular volume are interchangeable. Whilst skin turgor and hydration of mucous membranes may be "invaluable clues to the state of hydration" they have little bearing on the acute changes in intravascular volume that anaesthetists commonly encounter. There is also some doubt