title: Fluid Management in Patients with Trauma: Restrictive Versus Liberal Approach.
abstract: Massive hemorrhage remains a major cause of traumatic deaths. The ideal fluid resuscitative strategy is much debated. Research has provided inconsistent results regarding which fluid strategy is ideal; the optimum fluid type, timing, and volume remains elusive. Aggressive large-volume resuscitation has been the mainstay based on controlled hemorrhage animal models. For uncontrolled hemorrhagic shock, liberal fluid resuscitative strategies exacerbate the lethal triad, invoke resuscitative injury, and increase mortality while more restrictive fluid strategies tend to ameliorate trauma-induced coagulopathy and favor a greater chance of survival. This article discusses the current evidence regarding liberal and restrictive fluid strategies for trauma.
authors.affiliation: Wilford & Kate Bailey Small Animal Teaching Hospital, Auburn University, 1220 Wire Road, Auburn, AL 36849, USA. Electronic address: lpalmer2508@gmail.com.
authors.forename: Lee
authors.initials: L
authors.lastname: Palmer
mesh_terms: D000818:Animals; D005440:Fluid Therapy / Q000379:methods / Q000662:veterinary*; D006801:Humans; D007023:Hypotension, Controlled / Q000379:methods / Q000662:veterinary; D012151:Resuscitation / Q000379:methods / Q000662:veterinary*; D012771:Shock, Hemorrhagic / Q000628:therapy* / Q000662:veterinary*; D014947:Wounds and Injuries / Q000628:therapy / Q000662:veterinary
keywords: Damage controlled resuscitation; Hemorrhagic shock; Hemostatic resuscitation; Lethal triad; Permissive hypotension; Trauma