Optimal Fluid Therapy for Traumatic Hemorrhagic Shock

Ronald Chang; John B Holcomb

doi:10.1016/j.ccc.2016.08.007

Optimal Fluid Therapy for Traumatic Hemorrhagic Shock

Crit Care Clin. 2017 Jan;33(1):15-36. doi: 10.1016/j.ccc.2016.08.007.

Authors

Ronald Chang¹, John B Holcomb²

Affiliations

¹ Center for Translational Injury Research, University of Texas Health Science Center, 6410 Fannin Street, Suite 1100, Houston, TX 77030, USA. Electronic address: ronald.chang@uth.tmc.edu.
² Department of Surgery, University of Texas Health Science Center, 6410 Fannin Street, Suite 1100, Houston, TX 77030, USA.

Abstract

The resuscitation of traumatic hemorrhagic shock has undergone a paradigm shift in the last 20 years with the advent of damage control resuscitation (DCR). Major principles of DCR include minimization of crystalloid, permissive hypotension, transfusion of a balanced ratio of blood products, and goal-directed correction of coagulopathy. In particular, plasma has replaced crystalloid as the primary means for volume expansion for traumatic hemorrhagic shock. Predicting which patient will require DCR by prompt and accurate activation of a massive transfusion protocol, however, remains a challenge.

Keywords: Damage control resuscitation; Hemorrhagic shock; Massive transfusion protocol.

Publication types

Review

MeSH terms

Blood Transfusion / standards*
Fluid Therapy / standards*
Humans
Isotonic Solutions / therapeutic use*
Practice Guidelines as Topic*
Resuscitation / standards*
Shock, Hemorrhagic / diagnosis*
Shock, Hemorrhagic / therapy*

Substances

Isotonic Solutions

Grants and funding

T32 GM008792/GM/NIGMS NIH HHS/United States