Recent years have seen a renewed interest in the use of hypertonic-hyperoncotic solutions as plasma volume expanders for the treatment of hemorrhagic hypotension. In particular, a number of studies in experimental animals have addressed the efficacy and safety of small-volume infusions of 7.5% NaCI/6% dextran 70 (HSD). Employing models of fixed volume or fixed pressure hemorrhage, HSD has improved survival and reversed many of the hemodynamics, hormonal metabolic abnormalities associated with hemorrhagic shock. In the few human field trials completed to date, HSD has been shown to be potentially beneficial in hypotensive trauma patients who require surgery or have concomitatant head injury. Extensive toxicologic evaluations and lack of report of adverse effects in the human trials indicate that, at the proposed therapeutic dose of 4 mL/kg, HSD should present little risk.