Intravenous fluid resuscitation for the trauma patient

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose of review: Although longstanding practice in trauma care has been to provide immediate, aggressive intravenous fluid resuscitation to injured patients with presumed internal hemorrhage, recent experimental and clinical data suggest a more discriminating approach that first considers concurrent head injury, hemodynamic stability, and the presence of potentially uncontrollable hemorrhage (e.g., deep truncal injury) versus a controllable source (e.g., distal extremity wound). Recent findings: The data suggest that rapid intravenous fluid infusions could be used for patients with isolated extremity, thermal or head injury. However, intravenous fluids should be limited in conditions with potentially uncontrollable internal hemorrhage, and particularly in patients with penetrating truncal injury being transported immediately to a trauma center. Likewise, positive pressure ventilatory support should be limited with severe hemorrhage due to the secondary reductions in venous return off-setting the effects of the fluids. For trauma patients with severe bleeding, there is growing evidence for the increased use of plasma and factor VIIa, as well as tourniquets, intra-osseus devices, and evolving monitoring techniques. Summary: Future research efforts in trauma should focus on the timing and rate of infusions as well as the concept of infusing alternative intravenous resuscitative fluids such as hemoglobin-based oxygen carriers (HBOCs) and the use of hemostatic agents and special blood products.

Original languageEnglish (US)
Pages (from-to)283-288
Number of pages6
JournalCurrent Opinion in Critical Care
Volume16
Issue number4
DOIs
StatePublished - Aug 2010

Fingerprint

Resuscitation
Hemorrhage
Wounds and Injuries
Craniocerebral Trauma
Extremities
Factor VIIa
Tourniquets
Trauma Centers
Hemostatics
Intravenous Infusions
Hemoglobins
Hot Temperature
Hemodynamics
Oxygen
Pressure
Equipment and Supplies

Keywords

  • Colloid
  • Crystalloid
  • Fresh frozen plasma
  • Head injury
  • Hemoglobin-based oxygen carrier
  • Hemorrhage
  • Intravenous fluid
  • Resuscitation
  • Shock
  • Trauma

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Intravenous fluid resuscitation for the trauma patient. / Roppolo, Lynn P.; Wigginton, Jane G.; Pepe, Paul E.

In: Current Opinion in Critical Care, Vol. 16, No. 4, 08.2010, p. 283-288.

Research output: Contribution to journalArticle

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