End points in trauma management

Abstract

Fluid resuscitation following traumatic haemorrhage has historically been instituted as soon after injury as possible. Patients suffering from haemorrhagic shock may receive several liters of crystalloid, in addition to colloid solutions, in order to normalize blood pressure, heart rate, urine output and mental status, which are the traditional endpoints of resuscitation. Current theory and recent investigations have questioned this dogma. Resuscitation goals may be different when the patient is actively haemorrhaging and once bleeding has been controlled. Newer markers of tissue and organ system perfusion may allow a more precise determination of adequate resuscitation

Keywords

• Trauma; Resuscitation; Tissue hypoxia; Occult hypoperfusion; Perfusion