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Fluids, Blood Substitutes, and New Tools

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Penetrating Trauma

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Abstract

Fluid management can be one of the most critical decisions in patients with penetrating injuries. Patients with ongoing hemorrhage and/or third space loss often require significant replacement until control of the hemorrhage is obtained. Restoration of normal blood pressure until control of hemorrhage is obtained is controversial. Isotonic fluid is widely accepted as the initial fluid for resuscitation. Blood and blood products follow to replace ongoing losses. The role of colloids and the volume of resuscitation remain controversial. Whole blood may have a role in massive transfusion scenarios. Autotransfusion of processed blood from intraoperative and closed drainage systems is an adjunct when blood supplies are limited.

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References

  1. Guyton AC, Hall JE (eds) (2000) Textbook of medical physiology, 10th edn. WB Saunders Co., Philadelphia

    Google Scholar 

  2. ATLS (2004) Advanced trauma life support for doctors, 7th edn. American College of Surgeons Committee on Trauma, Chicago

    Google Scholar 

  3. Carrico CJ, Canizaro PC, Shires GT (1976) Fluid resuscitation following injury: rationale for the use of balanced salt solutions. Crit Care Med 4(2):46–54

    Article  PubMed  CAS  Google Scholar 

  4. Scheingraber S et al (1999) Rapid saline infusion produces hyperchloremic acidosis in patients undergoing gynecologic surgery. Anesthesiology 90(5):1265–1270

    Article  PubMed  CAS  Google Scholar 

  5. Kiraly LN 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

    Article  PubMed  Google Scholar 

  6. 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

    PubMed  CAS  Google Scholar 

  7. Communication (2009) NHLBI stops enrollment in study of concentrated saline for patients with shock for lack of survival benefit. NIH. http://public.nhlbi.nih.gov/newsroom/home/GetPressRelease.aspx?id=2632. Accessed on 7/11/2011

  8. Alderson P et al (200) Colloids versus crystalloids for fluid resuscitation in critically ill patients. Cochrane Database Syst Rev (2):CD000567

    Google Scholar 

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

    PubMed  CAS  Google Scholar 

  10. Kashuk JL et al (2008) Postinjury life threatening coagulopathy: is 1:1 fresh frozen plasma:packed red blood cells the answer? J Trauma 65(2):261–270; discussion 270–271

    Article  PubMed  Google Scholar 

  11. Perkins JG et al (2008) Massive transfusion and nonsurgical hemostatic agents. Crit Care Med 36(7 Suppl):S325–S339

    Article  PubMed  Google Scholar 

  12. 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

    Article  PubMed  Google Scholar 

  13. Ozmen V et al (1992) Autotransfusion of potentially culture-positive blood (CPB) in abdominal trauma: preliminary data from a prospective study. J Trauma 32(1):36–39

    Article  PubMed  CAS  Google Scholar 

  14. Bickell WH et al (1994) Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 331(17):1105–1109

    Article  PubMed  CAS  Google Scholar 

  15. Innerhofer P 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 

  16. Natanson C et al (2008) Cell-free hemoglobin-based blood substitutes and risk of myocardial infarction and death: a meta-analysis. JAMA 299(19):2304–2312

    Article  PubMed  CAS  Google Scholar 

  17. Moore EE 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

    Article  PubMed  Google Scholar 

  18. Holmes JF et al (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 

  19. Yaghoubian A et al (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 

  20. 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 

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA

    David C. Griffin

  2. Section of Burns/Trauma/Critical Care, University of Utah, 50 North 1900 East, Salt Lake City, UT, 84132, USA

    Raminder Nirula

Authors
  1. David C. Griffin
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  2. Raminder Nirula
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Corresponding author

Correspondence to David C. Griffin .

Editor information

Editors and Affiliations

  1. Dept. Surgery, Massachusetts General Hospital, Fruit Street 55, Boston, 02114, Massachusetts, USA

    George C. Velmahos

  2. Medical School, Dept. Surgery, University of Witwatersrand, York Road 7, Johannesburg, 2193, South Africa

    Elias Degiannis

  3. Klinik für Viszeral-, Thorax- und, Gefäßchirurgie, Univ.Klinikum Marburg, Baldingerstraße, Marburg, 35043, Germany

    Dietrich Doll

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© 2012 Springer Berlin Heidelberg

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Griffin, D.C., Nirula, R. (2012). Fluids, Blood Substitutes, and New Tools. In: Velmahos, G., Degiannis, E., Doll, D. (eds) Penetrating Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-20453-1_10

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  • DOI: https://doi.org/10.1007/978-3-642-20453-1_10

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-20452-4

  • Online ISBN: 978-3-642-20453-1

  • eBook Packages: MedicineMedicine (R0)

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