Trauma is the leading cause of death in young adults. Development of trauma centers in urban settings including emergency medical services has contributed greatly to the improved quality of trauma patient care. Based on animal experiments performed 3 decades ago, the traditional management of hypovolemic hemorrhagic shock includes adequate circulatory volume with aggressive initial infusion of crystalloid solution. However, in several recent animal studies, investigators have found that aggressive treatment with fluids before control of bleeding results in a higher mortality rate, especially if blood pressure is elevated. This notion has been supported by findings in a recent prospective, randomized study involving patients with penetrating injuries to the torso. This article discusses briefly the pathophysiology of shock and hemostasis and the current literature on fluid resuscitation, with emphasis an limited volume resuscitation in patients with penetrating thoracoabdominal injuries.
Controvesier in Trauma Resuscitation| February 01 1999
Limited Volume Resuscitation in Penetrating Thoracoabdominal Trauma
Elizabeth de Guzman, RN, BSN, CNA;
From the Ben Taub General Hospital, Baylor College of Medicine, Houston, Texas.
Reprint requests to Elizabeth de Guzman, RN, BSN, CNA, Director/Coordinator of Trauma Services, Ben Taub General Hospital, 1504 Taub Loop, Houston, TX 77030.
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Maregina N. Shankar, RN, BSN, MS;
AACN Adv Crit Care (1999) 10 (1): 61–68.
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Elizabeth de Guzman, Maregina N. Shankar, Kenneth L. Mattox; Limited Volume Resuscitation in Penetrating Thoracoabdominal Trauma. AACN Adv Crit Care 1 February 1999; 10 (1): 61–68. doi:
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