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Emerg Med Clin North Am. 2018 Feb;36(1):85-106. doi: 10.1016/j.emc.2017.08.009.

The Evolving Science of Trauma Resuscitation.

Author information

1
Emergency Medicine, Barts Health NHS Trust, Queen Mary University of London, London, UK.
2
Trauma Sciences, Blizard Institute, Queen Mary University of London, London, UK.
3
Emergency Medicine, Barts Health NHS Trust, London, UK.
4
Trauma and Neuroscience, Blizard Institute, Queen Mary University of London, London E1 2AT, UK; London's Air Ambulance, Barts Health NHS Trust, London, UK. Electronic address: k.brohi@qmul.ac.uk.

Abstract

This review summarizes the evolution of trauma resuscitation from a one-size-fits-all approach to one tailored to patient physiology. The most dramatic change is in the management of actively bleeding patients, with a balanced blood product-based resuscitation approach (avoiding crystalloids) and surgery focused on hemorrhage control, not definitive care. When hemostasis has been achieved, definitive resuscitation to restore organ perfusion is initiated. This approach is associated with decreased mortality, reduced duration of stay, improved coagulation profile, and reduced crystalloid/vasopressor use. This article focuses on the tools and methods used for trauma resuscitation in the acute phase of trauma care.

KEYWORDS:

Endothelial damage; Hemostasis; Hypovolemia; Trauma resuscitation; Trauma-induced coagulopathy; Viscoelastic hemostatic assays

PMID:
29132583
DOI:
10.1016/j.emc.2017.08.009
[Indexed for MEDLINE]

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