To the Editor: Everyone knows what happens when a cube of ice is dropped into a cup of hot coffee. The ice melts, and the coffee cools. To regain the original temperature, energy in the form of heat must be applied. An analogous situation appears to exist when intravenous fluids are administered at temperature below that of the body. Energy must be expended to heat the fluid to body temperature. This constitutes an obligatory energy loss, and may be a crucial factor to a patient in severe shock. As an example a 450-kg (1000-lb) horse in severe shock might be ….
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