title: The treatment of traumatic shock: recent advances and unresolved questions.
abstract: Uncontrolled bleeding remains a leading cause of potentially preventable death after trauma. Timely, adequate resuscitation in traumatic shock is an essential, lifesaving aspect of polytrauma care. Whilst basic principles in the treatment of traumatic shock remain the same-achieving hemorrhage control and replacing lost volume, the way this is achieved has changed significantly in the last five years. The abandonment of blood pressure driven uncontrolled fluid resuscitation, the introduction of the concept of hemostatic resuscitation, and the increasing use of massive transfusion protocols have all contributed to an improvement in timely access to various blood products. The increase in knowledge regarding the pathophysiology of trauma, the availability of adjuncts, and the array of resuscitation monitoring options available have all contributed to a potentially improved approach to resuscitation. The purpose of this report is to review the most important advances in traumatic shock therapy in the last five years.
authors.affiliation: Department of Traumatology, Division of Surgery, John Hunter Hospital, University of Newcastle, Newcastle, NSW, 2310, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Sisak
authors.affiliation: Department of Traumatology, Division of Surgery, John Hunter Hospital, University of Newcastle, Newcastle, NSW, 2310, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Dewar
authors.affiliation: Department of Traumatology, Division of Surgery, John Hunter Hospital, University of Newcastle, Newcastle, NSW, 2310, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Butcher
authors.affiliation: Department of Traumatology, Division of Surgery, John Hunter Hospital, University of Newcastle, Newcastle, NSW, 2310, Australia.
authors.forename: K
authors.initials: K
authors.lastname: King
authors.affiliation: Department of Traumatology, Division of Surgery, John Hunter Hospital, University of Newcastle, Newcastle, NSW, 2310, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Evans
authors.affiliation: Department of Traumatology, Division of Surgery, John Hunter Hospital, University of Newcastle, Newcastle, NSW, 2310, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Miller
authors.affiliation: Department of Traumatology, Division of Surgery, John Hunter Hospital, University of Newcastle, Newcastle, NSW, 2310, Australia.
authors.forename: O
authors.initials: O
authors.lastname: Yoshino
authors.affiliation: Department of Traumatology, Division of Surgery, John Hunter Hospital, University of Newcastle, Newcastle, NSW, 2310, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Harrigan
authors.affiliation: Department of Traumatology, Division of Surgery, John Hunter Hospital, University of Newcastle, Newcastle, NSW, 2310, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Bendinelli
authors.affiliation: Department of Traumatology, Division of Surgery, John Hunter Hospital, University of Newcastle, Newcastle, NSW, 2310, Australia. Zsolt.Balogh@hnehealth.nsw.gov.au.
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Balogh
keywords: Coagulation monitoring; Hemostatic resuscitation; Massive transfusion; Traumatic shock
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