2005, Number 2
PDF size: 110.78 Kb.
ABSTRACTHemorrhage is one of the most common contributors to mortality in trauma patients. In the 50’s the American College of Surgeons recommended surgical control and aggressive reanimation in those patients; this therapeutic modalities were based in experimental models developed at that time. The primary end-points suggested included: substitution of circulating blood volume with a relation 3:1 and the maintenance of blood pressure in normal values without considering hemorrhage control. Nevertheless, recent clinical evidence and new experimental models have brought out that those therapeutics modalities, including elevation of blood pressure previous to hemorrhage control, are deleterious, and actually increase mortality in this population. These observations contributed to development of permissive, deliberated and delayed hypotension as new alternatives in treatment of trauma patients with hemorrhage. The objective of this study is to review actual concepts in the management of hemorrhage in trauma patients.
Hameed S, Aird W, Cohn M. Oxygen delivery. Crit Care Med 2003;31:S658-667.
Dutton RP. Low-pressure resuscitation from hemorrhagic shock. Intern Anesthes Clin 2003;40:19-30.
Gutierrez G, Reines H, Gutierrez W. Hemorrhagic shock. Crit Care 2004;8:373-381.
Revell M, Greaves I, Porter K. Endpoints for fluid resuscitation in hemorrhagic shock. J Trauma 2003;54:S63-S67.
Holmes C, Walley K. Vasopressin in the ICU. Curr Opin Crit Care 2004;10:442-448.
McCunn M, Dutton R. End-points of resuscitation: how much is enough? Curr Opin Anaesthesiol 2000;13:147-153.
Khan SS, Gray RJ. Valvular emergencies. Cardiol Clin 1991;9:689.
Bond RF. Peripheral macro-and microcirculation. In: Schlag G, Redhl H, Eds. Pathophysiology of Shock, sepsis and organ failure. Berlin, Springer-Verlag. 1993.
Heaglund U. Systemic mediators released from the gut in critical illness. Crit Care Med 1993;21:S15-8.
Stern A, Susan A. Low-volume fluid resuscitation for presumed hemorrhagic shock: helpful or harmful. Curr Opin Crit Care 2001;7:422-430.
Baskett PS. ABC of major trauma. Management of hypovolemic shock. BMJ 1990;300:1453-1457.
Kreineier. Pathophysiology of fluid imbalance. Critical Care 2000;4:53-57.
Arumugam T, Shiels I, Trent M et al. The Role of the complement system in ischemia-reperfusion injury. Shock 2004;21:401-409.
Robert I, Phillip E, Bunn F et al. Is the normalization of blood pressure in bleeding trauma patients harmful? Lancet 2001;357:385-87.
Jorgensen KA, Stoffersen E. On the inhibitory effect of albumin on platelet aggregation. Thromb Res 1980;17:13-18.
Stibbe J, Kirby E. Inhibition of Ristocetin-induced aggregation by Haemaccel. BMJ 1975;2:750-751.
Bickell W, Wall M, Pepe P et al. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 1994;331:1105-1109.
Dalrymple-Hay M, Aitchison R, Collins P et al. Hydroxyethyl starch induced acquired von Willebrand´s disease. Clin Lab Haematol 1992;14:209-211.
Stump D, Strauss R, Henriksenn R et al. Effects of hydroxyethyl starch on blood coagulation, particularly factor VIII. Transfusion 1985;25:349-54.
Lucas CE, Ledgerwood A, Mammen E et al. Altered coagulation protein content fther albumin resuscitation. Ann Surg 1982;196:198-202.
Mardel SN, Saunders F, Ollerenshaw L et al. Reduced quality of in vitro clot formation with gelatin-based plasma substitutes. Lancet 1996;347:825.
Bailén R. Reversible myocardial dysfunction in critically ill, noncardiac patients. Crit Care Med 2002;30:6.
William C. Endothelium as an organ system. Crit Care Med 2004;32:s271-79.
Varela E, Cohn SM, Díaz I et al. Splanchinc perfusion during delayed, hypotensive, or aggressive fluid resuscitation from uncontrolled hemorrhage. Shock 2003;20:478-480.
Carrillo P, Takasu A, Safar P et al. Prolonged severe hemorrhagic shock and resuscitation in rats does not cause subtle brain damage. J Trauma 1998;45:238-249.
Greaves KM, Revell. Fluid Resuscitation in Pre-Hospital Trauma Care: a Consensus View. J R Coll Surg Edinb 2002;47:451-457.
Hai SA. Permissive hypotension an Evolving Concept in Trauma. J Pakist Trauma Med 2004;45:1-6.
Cannon WB, Fraser J, Cowell EM. The preventive treatment of wound shock. JAMA 1918;70:618.
Kreimeier SP, Peter K. Permissive hypotension. Scheweiz Med Wochenschr 2000;130:1516-1524.
Fowler R, Pepe E. Fluid resuscitation of the patient with major trauma. Curr Opin Anesthes 2002;15:173-178.
Committee on Trauma. Advanced Trauma Life Support Program for Physicians. Chicago: American College of Surgeons; 1997:75-110.
Martin RR, Bickell WH, Pepe PE, Burch JM et al. Prospective evaluation of preoperatory fluid resuscitation in hypotensive patients with penetrating truncal injury: a preliminary report. J Trauma 1992;33:354-361.
Blair SD, Janvrin SB, McCollum CN et al. Effect of early blood transfusion on gastrointestinal haemorrhage. Br J Surg 1996;73:783-785.
Dunham CM, Belzberg H, Lyles R et al. The rapid infusion system: a superior method for resuscitation of hypovolemic trauma patients. Resuscitation 1991;21:207-227.
Turner J, Nicholl J, Webber L et al. Randomized controlled trial of prehospital intravenous fluid replacement therapy in serious trauma. Health Techno Assess 2000;4:1-57.
Rady YM. Bench-to beside review: Resuscitation in the emergency department. Crit Care 2004;810.11186/cc2986.
Marcus C, Carr J et al. Monitoring of hemostasis in combat trauma patients military med. 2004;169(Suppl):S11-15.