Best evidence for fluid resuscitation nursing in hypovolemic shock patients in emergency care based on GRADE system

Yulian Wang; Jiansheng Lin; Yanhui Lin

doi:10.2478/abm-2026-0009

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Best evidence for fluid resuscitation nursing in hypovolemic shock patients in emergency care based on GRADE system

Asian Biomedicine

Volume 20 (2026): Issue 2 (April 2026)

By: Yulian Wang, Jiansheng Lin and Yanhui Lin

Open Access

|Apr 2026

Abstract

Background

Hypovolemic shock is a life-threatening condition frequently encountered in emergency care, resulting from significant blood or fluid loss that impairs oxygen delivery to vital organs. Common causes include trauma, surgery, gastrointestinal bleeding, and ruptured ectopic pregnancy. Prompt fluid resuscitation is critical, with nurses playing a central role in early recognition, timely intervention, and continuous monitoring.

Objective

To synthesise the best evidence for fluid resuscitation practices in hypovolemic shock and assess nursing knowledge and practice in emergency settings.

Methods

This systematic review was conducted using preferred reporting items for systematic reviews and metaanalyses (PRISMA) guidelines and evaluated through the grading of recommendations assessment, development, and evaluation (GRADE) system. Databases including PubMed, EMBASE, and Cochrane Library were searched for studies published between 2015 and 2024.

Results

The isotonic crystalloids are the preferred first-line therapy, with early goal-directed fluid administration and close patient monitoring improving outcomes. Nurse-led assessment and reassessment were key to guiding resuscitation and reducing complications. However, gaps in protocol adherence, documentation, and practice variation were identified. Knowledge deficits among nurses were also evident, highlighting the need for targeted training.

Conclusions

This review supports the development of a structured nursing guideline for managing hypovolemic shock, emphasising evidence-based fluid strategies and continuous clinical evaluation. Strengthening nursing competencies through education and standardised protocols can enhance emergency care delivery and patient survival.

References

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Articles in this issue

DOI: https://doi.org/10.2478/abm-2026-0009 | Journal eISSN: 1875-855X | Journal ISSN: 1905-7415

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Language: English

Page range: 72 - 84

Published on: Apr 30, 2026

Published by: Chulalongkorn University

In partnership with: Paradigm Publishing Services

Publication frequency: 6 issues per year

Keywords:

fluid resuscitation,

GRADE system,

hypovolemic shock,

isotonic crystalloids

Related subjects:

Medicine,

Assistive professions, nursing,

Basic medical science,

Basic medical science, other,

Clinical medicine,

Clinical medicine, other

© 2026 Yulian Wang, Jiansheng Lin, Yanhui Lin, published by Chulalongkorn University
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 20 (2026): Issue 2 (April 2026)