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Fluids, Blood Substitutes, and New Tools

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Penetrating Trauma
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Abstract

Hemorrhage following trauma is one of the most common causes of trauma-related death, second only to head injury. It also is the most common cause of shock in the traumatically injured patient. While intravenous (IV) fluid is an important piece in the management of the patient after trauma, control of the source of hemorrhage is vital to patient survival. Understanding the body’s response to volume depletion is key to determining the timing, type, and volume of fluid that each patient may require for resuscitation. Knowing the physiology of volume depletion as it relates to the depth of hemorrhagic shock and the body’s capacity to shift fluid from different compartments is necessary to patient survival.

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Recommended Reading

  1. Alderson P, Schierhout G, Roberts I, Bunn F (2000) Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev (2):CD000567. Philadelphia, Pa, USA. doi:10.1002/14651858.CD000567

  2. American College of Surgeons. Advanced trauma life support for doctors. Student course manual. 9th ed. Chicago, Illinois: American College of Surgeons; 2012

    Google Scholar 

  3. Bickell WH, Wall MJ, Pepe PE et al (1994) Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 331(17):1105–1109. doi:10.1056/NEJM199410273311701

    Article  CAS  PubMed  Google Scholar 

  4. Bridges LC, Waibel BH, Newell MA (2015) Permissive hypotension: potentially harmful in the elderly? A National Trauma Data Bank analysis. Am Surg 81(8):770–777

    PubMed  Google Scholar 

  5. Cotton BA, Jerome R, Collier BR et al (2009) Guidelines for prehospital fluid resuscitation in the injured patient. J Trauma 67(2):389–402. doi:10.1097/TA.0b013e3181a8b26f

    Article  PubMed  Google Scholar 

  6. Dubick MA, Shek P, Wade CE (2013) ROC trials update on prehospital hypertonic saline resuscitation in the aftermath of the US-Canadian trials. Clinics (Sao Paulo) 68(6):883–886. doi:10.6061/clinics/2013(06)25

    Article  Google Scholar 

  7. Dutton RP, Mackenzie CF, Scalea TM (2002) Hypotensive resuscitation during active hemorrhage: impact on in-hospital mortality. J Trauma 52(6):1141–1146

    Article  PubMed  Google Scholar 

  8. Dzik WH, Blajchman MA, Fergusson D et al (2011) Clinical review: Canadian National Advisory Committee on Blood and Blood Products–Massive transfusion consensus conference 2011: report of the panel. Bio Med Central Ltd 15:242. doi:10.1186/cc10498

    Google Scholar 

  9. Feinman M, Cotton BA, Haut ER (2014) Optimal fluid resuscitation in trauma: type, timing, and total. Curr Opin Crit Care 20(4):366–372. doi:10.1097/MCC.0000000000000104

    Article  PubMed  Google Scholar 

  10. Hall JE, Guyton AC (2011) Guyton and hall textbook of medical physiology. Saunders

    Google Scholar 

  11. Holcomb JB, Tilley BC, Baraniuk S et al (2015) Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA 313(5):471–482. doi:10.1001/jama.2015.12

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Holmes JF, Sakles JC, Lewis G, Wisner DH (2002) Effects of delaying fluid resuscitation on an injury to the systemic arterial vasculature. Acad Emerg Med 9(4):267–274

    Article  PubMed  Google Scholar 

  13. Innerhofer P, Fries D, Margreiter J et al (2002) The effects of perioperatively administered colloids and crystalloids on primary platelet-mediated hemostasis and clot formation. Anesth Analg 95(4):858–865, –table of contents

    PubMed  Google Scholar 

  14. Johansson PI, Stensballe J, Ostrowski SR (2012) Current management of massive hemorrhage in trauma. Scand J Trauma Resusc Emerg Med 20(1):47. doi:10.1186/1757-7241-20-47

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kashuk JL, Moore EE, Johnson JL, et al (2008) Postinjury life threatening coagulopathy: is 1:1 fresh frozen plasma:packed red blood cells the answer?. J Trauma 65(2):261–70–discussion270–1. doi:10.1097/TA.0b013e31817de3e1

  16. Kiraly LN, Differding JA, Enomoto TM, et al (2006) Resuscitation with normal saline (NS) vs. lactated ringers (LR) modulates hypercoagulability and leads to increased blood loss in an uncontrolled hemorrhagic shock swine model. J Trauma 61(1):57–64–discussion 64–65. doi:10.1097/01.ta.0000220373.29743.69

  17. Moore EE, Moore FA, Fabian TC et al (2009) Human polymerized hemoglobin for the treatment of hemorrhagic shock when blood is unavailable: the USA multicenter trial. J Am Coll Surg 208(1):1–13. doi:10.1016/j.jamcollsurg.2008.09.023

    Article  PubMed  Google Scholar 

  18. Natanson C, Kern SJ, Lurie P, Banks SM, Wolfe SM (2008) Cell-free hemoglobin-based blood substitutes and risk of myocardial infarction and death: a meta-analysis. JAMA 299(19):2304–2312. doi:10.1001/jama.299.19.jrv80007

    Article  CAS  PubMed  Google Scholar 

  19. Ozmen V, McSwain NE, Nichols RL, Smith J, Flint LM (1992) Autotransfusion of potentially culture-positive blood (CPB) in abdominal trauma: preliminary data from a prospective study. J Trauma 32(1):36–39

    Article  CAS  PubMed  Google Scholar 

  20. Perkins JG, Cap AP, Weiss BM, Reid TJ, Bolan CD, Bolan CE (2008) Massive transfusion and nonsurgical hemostatic agents. Crit Care Med 36(7 Suppl):S325–S339. doi:10.1097/CCM.0b013e31817e2ec5

    Article  PubMed  Google Scholar 

  21. Scheingraber S, Rehm M, Sehmisch C, Finsterer U (1999) Rapid saline infusion produces hyperchloremic acidosis in patients undergoing gynecologic surgery. Anesthesiology 90(5):1265–1270

    Article  CAS  PubMed  Google Scholar 

  22. Schulman AM, Claridge JA, Young JS (2002) Young versus old: factors affecting mortality after blunt traumatic injury. Am Surg 68(11):942–947, –discussion 947–948

    PubMed  Google Scholar 

  23. Smith JB, Pittet J-F, Pierce A (2014) Hypotensive Resuscitation. Curr Anesthesiol Rep 4(3):209–215. doi:10.1007/s40140-014-0064-7

    Article  PubMed  PubMed Central  Google Scholar 

  24. Spinella PC (2008) Warm fresh whole blood transfusion for severe hemorrhage: U.S. military and potential civilian applications. Crit Care Med 36(7 Suppl):S340–S345. doi:10.1097/CCM.0b013e31817e2ef9

    Article  PubMed  Google Scholar 

  25. Velanovich V (1989) Crystalloid versus colloid fluid resuscitation: a meta-analysis of mortality. Surgery 105(1):65–71

    CAS  PubMed  Google Scholar 

  26. Wade CE, Grady JJ, Kramer GC (2003) Efficacy of hypertonic saline dextran fluid resuscitation for patients with hypotension from penetrating trauma. J Trauma 54(5 Suppl):S144–S148. doi:10.1097/01.TA.0000047223.62617.AB

    CAS  PubMed  Google Scholar 

  27. Yaghoubian A, Lewis RJ, Putnam B, De Virgilio C (2007) Reanalysis of prehospital intravenous fluid administration in patients with penetrating truncal injury and field hypotension. Am Surg 73(10):1027–1030

    PubMed  Google Scholar 

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Correspondence to Lara Senekjian .

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Senekjian, L., Nirula, R. (2017). Fluids, Blood Substitutes, and New Tools. In: Velmahos, G., Degiannis, E., Doll, D. (eds) Penetrating Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49859-0_10

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  • DOI: https://doi.org/10.1007/978-3-662-49859-0_10

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