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BioMed Research International
Volume 2016, Article ID 8901938, 8 pages
http://dx.doi.org/10.1155/2016/8901938
Review Article

Hypotensive Resuscitation among Trauma Patients

1Trauma Services Department, The Medical Center of Plano, 3901 W. 15th Street, Plano, TX 75075, USA
2Department of Trauma Research, Medical Center of Plano, 3901 W. 15th Street, Plano, TX 75075, USA
3Department of Trauma Research, Swedish Medical Center, 501 E. Hampden Avenue, Englewood, CO 80113, USA
4Department of Trauma Research, St. Anthony Hospital, 11600 W. 2nd Place, Lakewood, CO 80228, USA
5Department of Trauma Research, Penrose Hospital, 2222 N. Nevada Avenue, Colorado Springs, CO 80907, USA
6Trauma Services Department, Swedish Medical Center, 501 E. Hampden Avenue, Englewood, CO 80113, USA
7Rocky Vista University, 8401 S. Chambers Road, Parker, CO 80134, USA
8Trauma Services Department, St. Anthony Hospital, 11600 W. 2nd Place, Lakewood, CO 80228, USA

Received 15 June 2016; Accepted 19 July 2016

Academic Editor: Aristomenis K. Exadaktylos

Copyright © 2016 Matthew M. Carrick et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hemorrhagic shock is a principal cause of death among trauma patients within the first 24 hours after injury. Optimal fluid resuscitation strategies have been examined for nearly a century, more recently with several randomized controlled trials. Hypotensive resuscitation, also called permissive hypotension, is a resuscitation strategy that uses limited fluids and blood products during the early stages of treatment for hemorrhagic shock. A lower-than-normal blood pressure is maintained until operative control of the bleeding can occur. The randomized controlled trials examining restricted fluid resuscitation have demonstrated that aggressive fluid resuscitation in the prehospital and hospital setting leads to more complications than hypotensive resuscitation, with disparate findings on the survival benefit. Since the populations studied in each randomized controlled trial are slightly different, as is the timing of intervention and targeted vitals, there is still a need for a large, multicenter trial that can examine the benefit of hypotensive resuscitation in both blunt and penetrating trauma patients.