Idea: Limit bleeding by limiting driving pressure
Physiologically reasonable however not born out in human mortality evidence.
Context: Falls under haemostatic resuscitation arm of triad of damage control resuscitation:
Stop the bleeding + Haemostatic resuscitation + Damage control surgery
BP Target: dependant on patient & co-morbidities specific
– Previously fit / well – SBP 80-90mmHg
– Elder / hypertensive – ? targeted to consciousness level
Fluid: 100-200ml bolus crystalloid in response to excess hypotension (& reassess end-points) NSW ACI Guidelines
Target end-point = Haemostasis
Schreiber MA, Meier EN, Tisherman SA, et al. A CONTROLLED RESUSCITATION STRATEGY IS FEASIBLE AND SAFE IN HYPOTENSIVE TRAUMA PATIENTS: RESULTS OF A PROSPECTIVE RANDOMIZED PILOT TRIAL. The journal of trauma and acute care surgery. 2015;78(4):687-697.