Sequelae of Massive Fluid Resuscitation in Trauma Patients

Rueden, Kathryn T. Von; Dunham, C. Michael

doi:10.1016/s0899-5885(18)30466-0

Cited by 4 publications

(1 citation statement)

References 44 publications

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“…Failure to rapidly achieve the required intravascular volume and to improve tissue perfusion to near normal levels results in an increased incidence of ARDS, multi‐system organ failure (MSOF) and a poorer outcome 18–20 .…”

Section: Aim Of Fluid Administration In Shockmentioning

confidence: 99%

The role of colloids in resuscitation

Vinen

1996

Emergency Medicine

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Colloids have been used for many years in resuscitation yet few studies have thoroughly examined their usefulness. Colloids and a combination of crystalloids and colloids continue to be used without any real scientific basis. Scrutiny of review articles, experimental studies, and clinical investigations reveals conflicting and confusing data. There are too many variables to accurately interpret findings, cross species problems with animal studies, different fluids used making comparisons difficult if not impossible, and confounding variables that include: Health status of the patients Severity/type of injury Complications (especially sepsis) Varying grades of shock Variable time scale of administration of fluids Variable volumes administered Differing methods of determining fluid volume depletion Inconsistent monitoring Differing endpoints Different techniques to measure endpoints Comparison of delayed treatment of traumatic shock with blood loss occurring during surgery of questionable validity. One of the areas that has been studied reasonably well is the allergic effects associated with colloid use and more recently the adverse effects associated with the use of dextrose solutions in patients with head injuries. The continued effort to develop satisfactory resuscitation solutions including the recent development of hypertonic saline solutions (usually in combination with a colloid) highlights the uncertainty that exists in relation to the true role of the colloid and crystalloid agents available. Recent studies question the use of fluids to resuscitate patients with penetrating torso injuries. The aim of this paper is to review what is known about the use of colloids and crystalloids in resuscitation and to recommend guidelines as to which fluid should be used in differing clinical situations.

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Section: Aim Of Fluid Administration In Shockmentioning

confidence: 99%

The role of colloids in resuscitation

Vinen

1996

Emergency Medicine

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Hypothermic Coagulopathy in Trauma

Watts

Trask

Soeken

et al. 1998

The Journal of Trauma: Injury, Infection, and Critical Care

400

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Patients whose temperature was > or =34.0 degrees C actually demonstrated a significant hypercoagulability. Enzyme activity slowing and decreased platelet function individually contributed to hypothermic coagulopathy in patients with core temperatures below 34.0 degrees C. All the coagulation measures affected are part of the polymerization process of platelets and fibrin, and this process may be the mechanism by which the alteration in coagulation occurs.

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Coagulopathies in Trauma Patients

Lapointe¹,

Rueden²

2002

AACN Clinical Issues: Advanced Practice in Acute and Critical C

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Coagulopathy after traumatic injury has multiple etiologies. It may result from overwhelming activation of tissue factor, consumption of circulating coagulation proteins, massive transfusion, metabolic alterations, hypothermia, or any combination of these factors. Despite advances in trauma resuscitation, the problem of persistent, life-threatening coagulopathy continues to pose a significant challenge for the healthcare team, and sometimes is an insurmountable obstacle in the path to recovery of the patient with trauma. Development of a coagulopathy has a significant impact on the morbidity and mortality of the patient with trauma. This article describes the relevant pathophysiology as it relates to the development of a coagulopathy, prevention strategies, and management principles applied in caring for the patient with trauma and a coagulopathy.

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Sequelae of Massive Fluid Resuscitation in Trauma Patients

Cited by 4 publications

References 44 publications

The role of colloids in resuscitation

The role of colloids in resuscitation

Hypothermic Coagulopathy in Trauma

Coagulopathies in Trauma Patients

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