Silvia Coppola1, Sara Froio, Davide Chiumello. 1. Dipartimento di Anestesia Rianimazione (Intensiva e Subintensiva) e Terapia del Dolore, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
Abstract
PURPOSE OF REVIEW: Fluid resuscitation in trauma patients could reduce organ failure, until blood components are available and hemorrhage is controlled. However, the ideal fluid resuscitation strategy in trauma patients remains a debated topic. Different types of trauma can require different types of fluids and different volume of infusion. RECENT FINDINGS: There are few randomized controlled trials investigating the efficacy of fluids in trauma patients. There is no evidence that any type of fluids can improve short-term and long-term outcome in these patients. The main clinical evidence emphasizes that a restrictive fluid resuscitation before surgery improves outcome in patients with penetrating trauma. Fluid management of blunt trauma patients, in particular with coexisting brain injury, remains unclear. SUMMARY: In order to focus on the state of the art about this topic, we review the current literature and guidelines. Recent studies have underlined that the correct fluid resuscitation strategy can depend on the type of trauma condition: penetrating, blunt, brain injury or a combination of them. Of course, further studies are needed to investigate the impact of a specific fluid strategy on different type and severity of trauma.
PURPOSE OF REVIEW: Fluid resuscitation in traumapatients could reduce organ failure, until blood components are available and hemorrhage is controlled. However, the ideal fluid resuscitation strategy in traumapatients remains a debated topic. Different types of trauma can require different types of fluids and different volume of infusion. RECENT FINDINGS: There are few randomized controlled trials investigating the efficacy of fluids in traumapatients. There is no evidence that any type of fluids can improve short-term and long-term outcome in these patients. The main clinical evidence emphasizes that a restrictive fluid resuscitation before surgery improves outcome in patients with penetrating trauma. Fluid management of blunt traumapatients, in particular with coexisting brain injury, remains unclear. SUMMARY: In order to focus on the state of the art about this topic, we review the current literature and guidelines. Recent studies have underlined that the correct fluid resuscitation strategy can depend on the type of trauma condition: penetrating, blunt, brain injury or a combination of them. Of course, further studies are needed to investigate the impact of a specific fluid strategy on different type and severity of trauma.
Authors: Clementina Duran Palma; Musawenkosi Mamba; Johan Geldenhuys; Oluwafolajimi Fadahun; Rolf Rossaint; Kai Zacharowski; Martin Brand; Óscar Díaz-Cambronero; Javier Belda; Martin Westphal; Ute Brauer; Dirk Dormann; Tamara Dehnhardt; Martin Hernandez-Gonzalez; Sonja Schmier; Dianne de Korte; Frank Plani; Wolfgang Buhre Journal: Trials Date: 2022-06-02 Impact factor: 2.728
Authors: Oliver Grottke; Joanne van Ryn; Christian Zentai; Guanfa Gan; Markus Honickel; Rolf Rossaint; Hugo Ten Cate; Henri M H Spronk Journal: PLoS One Date: 2019-01-07 Impact factor: 3.240
Authors: Sharon R Lewis; Michael W Pritchard; David Jw Evans; Andrew R Butler; Phil Alderson; Andrew F Smith; Ian Roberts Journal: Cochrane Database Syst Rev Date: 2018-08-03