Immediate versus Delayed Fluid Resuscitation for Hypotensive Patients with Penetrating Torso Injuries

Bickell, William H; Wall, Matthew J.; Pepe, Paul E.; Martin, R. Russell; Ginger, Victoria F.; Allen, Mary K.; Mattox, Kenneth L.

doi:10.1056/nejm199410273311701

Cited by 1,975 publications

(943 citation statements)

References 18 publications

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“…Bickell et al 23 compared the effects of immediate (before surgical intervention) and delayed (after entering the hospital) fluid resuscitation with isotonic crystalloid in 598 hypotensive patients (systolic blood pressure <90 mm Hg) with penetrating torso injuries from gunshot or stab wounds. Mortality was lower (P = .04) in the 289 patients who received delayed resuscitation (38.9%; 86 fatalities) than in the 309 patients who received immediate resuscitation (37.5%; 116 fatalities).…”

Section: Studies Of Permissive Hypotension In Humansmentioning

confidence: 99%

Permissive Hypotension in Bleeding Trauma Patients: Helpful or Not and When?

Gourgiotis

Gemenetzis

Kocher

et al. 2013

Critical Care Nurse

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T rauma remains the leading cause of mortality among persons 1 to 44 years old in the United States 1 and accounts for almost 9% of total mortality worldwide. 2 In 2008 a total of 663000 injury-related deaths occurred in Europe (6.9% of total deaths). 2 Uncontrolled bleeding and exsanguination are the leading cause of preventable death after trauma 3 and require early detection of potential bleeding sources and prompt action to minimize blood loss, restore tissue perfusion, and achieve a stable hemodynamic status. Permissive Hypotension in CNE Continuing Nursing EducationCover 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. (Critical Care Nurse. 2013;33[6]:18-25)

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Section: Studies Of Permissive Hypotension In Humansmentioning

confidence: 99%

Permissive Hypotension in Bleeding Trauma Patients: Helpful or Not and When?

Gourgiotis

Gemenetzis

Kocher

et al. 2013

Critical Care Nurse

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“…Although recent studies (Bickell 1994) have suggested that the timing of volume replacement deserves careful consideration, when it comes to selecting the resuscitation fluid clinicians are faced with a range of options. At one level the choice is between a colloid or crystalloid solution.…”

Section: B a C K G R O U N Dmentioning

confidence: 99%

Colloids versus crystalloids for fluid resuscitation in critically ill patients

Alderson

Schierhout²,

Roberts³

et al. 2000

Cochrane Database of Systematic Reviews

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“…In that study, the patient group that underwent only securing of an i.v. line as much as possible, without transfusion, until operating room admission had a higher survival rate 8. Pepe et al 2.…”

Section: Discussionmentioning

confidence: 99%

Preoperative fluid restriction for trauma patients with hemorrhagic shock decreases ventilator days

Matsuyama

Miki

Kittaka

et al. 2018

Acute Medicine & Surgery

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AimIn recent years, with the concept of damage control resuscitation, hemostasis and preoperative fluid restriction have been carried out, but there is controversy regarding the effectiveness of fluid restriction.MethodsFrom April 2007 to March 2013, 101 trauma patients presented with hemorrhagic shock (systolic blood pressure ≤90 mmHg) at the prehospital or emergency department and were admitted to Hyogo Emergency Medical Center (Hyogo, Japan). They underwent emergency hemostasis by surgery and transcatheter arterial embolization. We compared two groups in a historical cohort study, the aggressive fluid resuscitation (AR) group, which included 59 cases treated in the period April 2007–March 2010, and the fluid restriction (FR) group, which included 42 cases treated in the period April 2010–March 2013.ResultsThere was no difference between both groups in patient background (heart rate, 110 b.p.m.; systolic blood pressure, 70 mmHg). The Injury Severity Score was 34 (AR) versus 38 (FR) (not significant). Preoperative infusion volume of crystalloid significantly decreased, from 2310 mL (AR) to 1025 mL (FR) (P ≤ 0.01). There was no difference in mortality (36% [AR] versus 41% [FR]). Ventilator days significantly decreased, from 8.5 days (AR) to 5.5 days (FR) (P = 0.02).ConclusionsPreoperative fluid restriction for trauma patients with hemorrhagic shock did not improve mortality, but it decreased ventilator days by reducing the perioperative plus water balance and it might contribute to perioperative intensive care.

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Immediate versus Delayed Fluid Resuscitation for Hypotensive Patients with Penetrating Torso Injuries

Abstract: Background Fluid resuscitation may be detrimental when given before bleeding

Cited by 1,975 publications

References 18 publications

Permissive Hypotension in Bleeding Trauma Patients: Helpful or Not and When?

Permissive Hypotension in Bleeding Trauma Patients: Helpful or Not and When?

Colloids versus crystalloids for fluid resuscitation in critically ill patients

Preoperative fluid restriction for trauma patients with hemorrhagic shock decreases ventilator days

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