Hypotensive resuscitation.
While the mechanism remains unclear, a growing body of experimental and clinical evidence suggests that aggressive crystalloid resuscitation in near fatal uncontrolled hemorrhage is associated with poor outcome. Limited attempts to restore blood pressure improve cardiac output, tissue perfusion, and survival while attempts to restore normal tension with crystalloid result in increased hemorrhage volume and higher mortality. The current standard of therapy for treatment of hemorrhagic shock includes initial aggressive crystalloid resuscitation. This mini-review summarizes some of the experimental and clinical data suggesting that this approach may not be desirable in the presence of uncontrolled hemorrhage following injury.
Dries
D J
DJ
Department of Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.
D000818:Animals; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D006470:Hemorrhage / Q000401:mortality / Q000628:therapy*; D006801:Humans; D006982:Hypertonic Solutions / Q000627:therapeutic use*; D007022:Hypotension / Q000628:therapy; D010952:Plasma Substitutes / Q000627:therapeutic use; D012151:Resuscitation / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome
D006982:Hypertonic Solutions; D010952:Plasma Substitutes