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.

http://lifeinthefastlane.com/ccc/permissive-hypotension/

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