Severity of hemorrhage and rate of bleeding are fundamental factors in the outcomes of trauma. Intravenous administration of fluid is the basic treatment to maintain blood pressure until bleeding is controlled. The main guideline, used almost worldwide, Advanced Trauma Life Support, established by the American College of Surgeons in 1976, calls for aggressive administration of intravenous fluids, primarily crystalloid solutions. Several other guidelines, such as Prehospital Trauma Life Support, Trauma Evaluation and Management, and Advanced Trauma Operative Management, are applied according to a patient’s current condition. However, the ideal strategy remains unclear. With permissive hypotension, also known as hypotensive resuscitation, fluid administration is less aggressive. The available models of permissive hypotension are based on hypotheses in hypovolemic physiology and restricted clinical trials in animals. Before these models can be used in patients, randomized, controlled clinical trials are necessary.
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1 December 2013
ARTICLE|
December 01 2013
Permissive Hypotension in Bleeding Trauma Patients: Helpful or Not and When?
Stavros Gourgiotis, MD, PhD;
Stavros Gourgiotis, MD, PhD
Stavros Gourgiotis is a surgeon consultant, 2nd Department of Surgery, 401 General Military Hospital, Athens, Greece.
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George Gemenetzis, MD;
George Gemenetzis is a resident (PGY 2), 2nd Department of Surgery, 401 General Military Hospital.
Corresponding author: George Gemenetzis, md, Resident (PGY 2), 4th Dept of Surgery, Attikon University Hospital, Rimini 1 12462, Chaidari, Attiki, Greece (e-mail: [email protected]).
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Hemant M. Kocher, MD, FRCS;
Hemant M. Kocher, MD, FRCS
Hemant M. Kocher is a surgeon consultant, Barts and the London HPB Centre, Royal London Hospital, London, United Kingdom.
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Stavros Aloizos, MD;
Stavros Aloizos, MD
Stavros Aloizos is an anesthesiologist and director of the intensive care unit, 401 General Military Hospital.
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Nikolaos S. Salemis, MD, PhD;
Nikolaos S. Salemis, MD, PhD
Nikolaos S. Salemis is a surgeon and director of the breast cancer unit, 401 General Military Hospital.
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Stylianos Grammenos, MD
Stylianos Grammenos, MD
Stylianos Grammenos is a resident (PGY 4), 2nd Department of Surgery, 401 General Military Hospital.
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Crit Care Nurse (2013) 33 (6): 18–24.
Citation
Stavros Gourgiotis, George Gemenetzis, Hemant M. Kocher, Stavros Aloizos, Nikolaos S. Salemis, Stylianos Grammenos; Permissive Hypotension in Bleeding Trauma Patients: Helpful or Not and When?. Crit Care Nurse 1 December 2013; 33 (6): 18–24. doi: https://doi.org/10.4037/ccn2013395
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