An Update in Early Fluid Resuscitation in Trauma Patient

Abstract

Hemorrhage is the most common preventable cause of death in the setting of trauma.

During recent decades, despite our increasing knowledge of the pathophysiology of hemorrhagic shock in trauma patients, the mortality rate continues to remain high.

About one-third of trauma patients will develop a coagulopathy if their hemorrhage leads to multiple organ failure (MOF).

Goals of treatment in trauma patients remain avoiding metabolic acidosis, hypothermia, treating coagulopathy and stabilizing the patient as soon as possible.

Adequate volume therapy appears to be fundamental in the management of the trauma patient.

A large volume crystalloid resuscitation, followed by several units of packed red blood cells then a modest amount of fresh frozen plasma and platelets was accepted as the standard for decades. This is no longer considered appropriate. Resuscitation of the severely injured patient is a topic of ongoing evolution and controversy.

The choice of fluid therapy engenders the most controversy, and an examination of the body of literature on this subject results in confusion.

Irreversible tissue damage, and even death, may occur despite adequate but delayed resuscitation.