title: Fluid resuscitation in trauma patients: what should we know?
abstract: OBJECTIVE
  Fluid resuscitation in trauma patients could reduce organ failure, until blood components are available and hemorrhage is controlled. However, the ideal fluid resuscitation strategy in trauma patients remains a debated topic. Different types of trauma can require different types of fluids and different volume of infusion.
  
  
  RESULTS
  There are few randomized controlled trials investigating the efficacy of fluids in trauma patients. There is no evidence that any type of fluids can improve short-term and long-term outcome in these patients. The main clinical evidence emphasizes that a restrictive fluid resuscitation before surgery improves outcome in patients with penetrating trauma. Fluid management of blunt trauma patients, in particular with coexisting brain injury, remains unclear.
  
  
  CONCLUSIONS
  In order to focus on the state of the art about this topic, we review the current literature and guidelines. Recent studies have underlined that the correct fluid resuscitation strategy can depend on the type of trauma condition: penetrating, blunt, brain injury or a combination of them. Of course, further studies are needed to investigate the impact of a specific fluid strategy on different type and severity of trauma.
authors.affiliation: Dipartimento di Anestesia Rianimazione (Intensiva e Subintensiva) e Terapia del Dolore, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Coppola
authors.forename: Sara
authors.initials: S
authors.lastname: Froio
authors.forename: Davide
authors.initials: D
authors.lastname: Chiumello
mesh_terms: D001930:Brain Injuries / Q000628:therapy; D005440:Fluid Therapy; D006801:Humans; D012151:Resuscitation / Q000379:methods; D014947:Wounds and Injuries / Q000628:therapy*