Resuscitation in disasters must be effective, prompt, safe and uncomplicated. Clinical experience in severe, extensive thermal burns in numerous clinics has shown that balanced hypertonic sodium solution (BHSS) can achieve effective resuscitation with: administration of less volume of fluid; early onset of excretion of sodium-containing urine; less generalized edema and without pulmonary edema. This experience is now being transferred to patients after trauma and major surgical procedures often complicated by peritonitis. In an ongoing study of randomly selected adults following surgical trauma, either Ringer's lactate (RL) or the BHSS (0.9% NaCl plus 100ml of one molar sodium acetate, total 1100ml yielding Na230, Cl 140, acetate 90mEq/l) was administered. All patients received daily (or more frequent) electrolyte and osmotic analyses of plasma and urine, continuous ICU monitoring of pulmonary and cardiac function, and similar wound care.