Not only has the optimal solution for resuscitation after traumatic injury been hotly contested, so too has the concept of resuscitation at all prior to definitive hemorrhage control . The ideal resuscitation strategy following penetrating or blunt trauma associated with hypoperfusion to provide maximal survival remains to be defined. Currently, there is a trend towards limited volume resuscitation instead of aggressive crystalloid volume expansion. Vitally related to these controversies are the debated endpoints of resuscitation — physiological and metabolic markers of the adequacy of resuscitation . Ideally, these markers should reflect changes in both systemic and microcirculatory flow. Increasingly evidence suggests that this is not the case. Moreover, the immunomodulatory effects of resuscitation and resuscitation fluids have influenced the casual selection of fluid type and amount for plasma volume expansion. This paper will explore the current state of trauma resuscitation ,with a particular focus on the acid-base sequelae of resuscitation, the impact of these sequelae, and their interpretation on the endpoints of resuscitation, potentially useful strategies to aid in resuscitation, and future areas of investigation.
KeywordsLactate Ringer Hydroxyethyl Starch Advance Trauma Life Support Plasma Volume Expansion Trauma Resuscitation
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