Current controversies in shock and resuscitation.
Many controversies and uncertainties surround resuscitation of hemorrhagic shock caused by vascular trauma. Whereas the basic pathophysiology is better understood, much remains to be learned about the many immunologic cascades that lead to problems beyond those of initial fluid resuscitation or operative hemostasis. Fluid therapy is on the verge of significant advances with substitute oxygen carriers, yet surgeons are still beset with questions of how much and what type of initial fluid to provide. Finally, the parameters chosen to guide therapy and the methods used to monitor patients present other interesting issues.
Orlinsky
M
M
Department of Emergency Medicine, University of Southern California, Keck School of Medicine, Los Angeles County and University of Southern California Medical Center, Los Angeles 90033, USA. orlinsky@hsc.usc.edu
Shoemaker
W
W
Reis
E D
ED
Kerstein
M D
MD
D001692:Biological Transport; D001803:Blood Transfusion; D002302:Cardiac Output; D004784:Environmental Monitoring; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D010100:Oxygen / Q000378:metabolism; D012771:Shock, Hemorrhagic / Q000503:physiopathology / Q000628:therapy*
D010100:Oxygen