There are a number of options for resuscitative fluids. Which of the following statement(s) is/are true concerning fluids used for resuscitation of shock?

c. Risks of autotransfused blood include disseminated intravascular coagulation and activation of fibrinolysis

d. Hypertonic saline solution results in volume expansion, an increase in left ventricular performance, decreased peripheral resistance, and redistribution of cardiac output to kidneys and viscera

Balanced salt solutions are the most commonly used resuscitative fluids, and their use to restore extracellular volume significantly decreases the transfusion requirement after hemorrhagic shock. Lactated Ringers and normal saline are the most effective crystalloid solutions in common use. Resuscitation with crystalloid require a volume administration ratio of 3:1 to 4:1 over volume lost. Although colloids do not replete the interstitial space, they have a volume-expanding effect somewhat greater than the amount used. Colloids commonly used for volume expansion in hypovolemia include albumen, dextran 70, dextran 40, and hydroxyethyl starch (hetastarch). Significant controversy exists concerning the use of crystalloid versus colloid resuscitation. Although the question has not been resolved, several recent studies have indicated an advantage to crystalloid in resuscitation. A meta-analysis of colloid versus crystalloid resuscitation after hemorrhagic shock has demonstrated a higher mortality rate in the colloid resuscitated patients, partly due to pulmonary complications. Patients who lose more than 25 to 30% of total blood volume will need blood for resuscitation. Type O, Rh-negative (universal donor blood) is immediately available without a cross match. Type-specific blood is available within most blood banks within five to ten minutes of receipt of the blood specimen, while the patient is being resuscitated with balanced salt solutions. Although not cross matched, this blood can be administered safely, and therefore its rapid availability and safety make type-specific blood the blood of choice for resuscitation in trauma. Autotransfusion involves the collection of shed blood and its reinfusion through a filter back into the patient. Autotransfused blood may produce disseminated intravascular coagulation (DIC) and activation of fibrinolysis. In addition, blood collected from the peritoneal cavity after hollow viscus injury, even with cell washing, may lead to bacterial contamination of the autotransfused blood. Hypertonic solutions have been used in the resuscitation of patients after burn, shock, elective vascular surgery and trauma. In addition to volume expansion, hypertonic saline solutions have been shown to increase left ventricular performance, decrease peripheral resistance from arteriolar dilatation, and redistribute cardiac output to the kidneys and viscera. Perfluorocarbons are an experimental resuscitation fluid comprised of large, branched or cyclic aliphatic compounds which have the ability to dissolve and carry oxygen. Although effective in volume resuscitation with improved oxygen delivery and oxygen-carrying capacity, perfluorocarbon infusion has been shown to depress platelet counts, plasma immune globulin levels and depress other aspects of immune function.