Current trends in resuscitation strategy for the multiply injured patient.
The ideal resuscitation strategy for multiply injured patients remains a topic of ongoing debate. At present, no consensus has been reached on the ideal fluid for early resuscitation and on the threshold for blood product transfusions. The concept of "permissive hypotension" for bleeding trauma patients furthermore contributes to the controversy in the field, particularly as it relates to blunt trauma and to patients with associated head injuries. Finally, postinjury coagulopathy is a poorly defined entity, and current resuscitation strategies lack strong evidence-based scientific support. This review article provides a brief overview of the existing resuscitation protocols for multiply injured patients, including ATLS and "damage control", and will address developing controversies in the field.
Stahel
Philip F
PF
Department of Orthopaedic Surgery, University of Colorado, Denver, Colorado 80204, USA. philip.stahel@dhha.org
Smith
Wade R
WR
Moore
Ernest E
EE
D000465:Algorithms; D001778:Blood Coagulation Disorders / Q000209:etiology / Q000628:therapy*; D001803:Blood Transfusion / Q000379:methods*; D002985:Clinical Protocols; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D008020:Life Support Care / Q000379:methods; D009104:Multiple Trauma / Q000150:complications / Q000628:therapy*; D017410:Practice Guidelines as Topic; D012151:Resuscitation / Q000379:methods* / Q000639:trends; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D012771:Shock, Hemorrhagic / Q000628:therapy; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy
D012462:Saline Solution, Hypertonic