Early fluid resuscitation in haemorrhagic shock.

For 25 years aggressive prehospital fluid administration in trauma patients has been common practice. Recent studies suggest that this may increase mortality in patients with hypovolaemic shock. These studies include retrospective analysis of patient survival, computer modelling of volume loss and replacement, controlled animal experiments, and clinical studies of trauma patients. Fluid resuscitation before definitive haemostasis has been achieved, may accelerate blood loss, cause hypothermia and result in a dilutional coagulopathy. Further studies are needed to establish optimum volume replacement in trauma patients with hypovolaemic shock.