Optimal Fluid Therapy for Traumatic Hemorrhagic Shock

Crit Care Clin. 2017 Jan;33(1):15-36. doi: 10.1016/j.ccc.2016.08.007.


The resuscitation of traumatic hemorrhagic shock has undergone a paradigm shift in the last 20 years with the advent of damage control resuscitation (DCR). Major principles of DCR include minimization of crystalloid, permissive hypotension, transfusion of a balanced ratio of blood products, and goal-directed correction of coagulopathy. In particular, plasma has replaced crystalloid as the primary means for volume expansion for traumatic hemorrhagic shock. Predicting which patient will require DCR by prompt and accurate activation of a massive transfusion protocol, however, remains a challenge.

Keywords: Damage control resuscitation; Hemorrhagic shock; Massive transfusion protocol.

Publication types

  • Review

MeSH terms

  • Blood Transfusion / standards*
  • Fluid Therapy / standards*
  • Humans
  • Isotonic Solutions / therapeutic use*
  • Practice Guidelines as Topic*
  • Resuscitation / standards*
  • Shock, Hemorrhagic / diagnosis*
  • Shock, Hemorrhagic / therapy*


  • Isotonic Solutions