The use of salt (specifically, isotonic saline or sodium chloride solution) in the treatment of shock has strong scientific validation and is a cornerstone of modern emergency and critical care medicine. Shock, particularly hypovolemic shock (caused by loss of blood or fluids), leads to a critical decrease in circulating blood volume and blood pressure, resulting in insufficient tissue perfusion and oxygenation. Rapid restoration of intravascular volume is essential to prevent organ failure and death.

Isotonic saline (0.9% sodium chloride) is widely used for intravenous fluid resuscitation in various types of shock, including hypovolemic and septic shock. Clinical guidelines, such as those from the American College of Surgeons (ATLS) and the Surviving Sepsis Campaign, recommend the prompt administration of crystalloid solutions like normal saline as first-line therapy. Numerous randomized controlled trials and meta-analyses have demonstrated that saline restores circulating volume, improves blood pressure, and enhances tissue perfusion, making it a critical intervention in acute shock management.

There is ongoing debate regarding the optimal resuscitation fluid (e.g., balanced crystalloids vs. normal saline), but the role of sodium chloride solution in the initial management of shock is undisputed. The strong scientific evidence supporting the use of salt-based solutions in shock resuscitation justifies a maximum evidence rating.