title: The ebb and flow of fluid (as in resuscitation).
abstract: Since the early 1960's "resuscitation" following major trauma involved use of replacement crystalloid fluid/estimated blood loss in volumes of 3/1, in the ambulance, emergency room, operating room and surgical intensive care unit. During the past 20 years, MAJOR paradigm shifts have occurred in this concept. As a result hypotensive resuscitation with a view towards restriction of crystalloid, and prevention of complications has occurred. Improved results in both civilian and military environments have been reported. As a result there is new focus on trauma surgical involvement in all aspects of trauma patient management, focus on early aggressive surgical approaches (which may or may not involve an operation), and movement from crystalloid to blood, plasma, and platelet replacement therapy.
authors.affiliation: Baylor College of Medicine, Ben Taub General Hospital, One Baylor Plaza, Houston, TX, USA, KMattox@aol.com.
authors.forename: K L
authors.initials: KL
authors.lastname: Mattox
mesh_terms: D000077324:Crystalloid Solutions; D004632:Emergency Medical Services / Q000266:history / Q000379:methods / Q000639:trends*; D017707:Erythrocyte Transfusion / Q000639:trends; D005440:Fluid Therapy / Q000266:history / Q000379:methods / Q000639:trends*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007022:Hypotension / Q000266:history / Q000628:therapy*; D007552:Isotonic Solutions / Q000008:administration & dosage; D012151:Resuscitation / Q000266:history / Q000379:methods* / Q000639:trends*; D012771:Shock, Hemorrhagic / Q000266:history / Q000628:therapy*; D013997:Time Factors
chemical_list: D000077324:Crystalloid Solutions; D007552:Isotonic Solutions