Fluid resuscitation and blood replacement in patients with polytrauma.

摘要: Hemorrhage is the most common cause of shock in patients with polytrauma, leading to cellular hypoxia and death. A large body experimental clinical research has greatly expanded our knowledge mechanisms outcomes resuscitation hypovolemic shock. However, fundamental principles fluid have not changed during past few decades. Aggressive correct tissue hypoperfusion within 24 hours injury associated improved outcomes. Initial volume expanders choice are crystalloid solutions, blood products used for who hemodynamically unstable, Class III IV hemorrhage, ongoing uncontrolled sources bleeding. The incidence immunologic infectious complications transfusions polytrauma been shown be any higher than other settings. Massive resuscitations, however, specific such as hypothermia, coagulopathy, abdominal compartment syndrome. Novel substitutes, hypertonic saline, minimally invasive hemodynamic monitoring techniques potential optimizing polytrauma. Additional using standardized animal models randomized trials needed.