Volume Management and Resuscitation in Trauma

Trauma remains an enormous burden on the American medical system. While patients of all ages sustain severe trauma, it remains the most common cause of death in young adults. Exsanguination from uncontrolled hemorrhage is the leading cause of preventable death among the traumatically injured. The lethal triad of trauma is a culmination of coagulopathy, acidosis, and hypothermia that can rapidly deteriorate and lead to a patient’s demise if not treated accordingly. The goal of trauma resuscitation is to prevent or halt this triad while minimizing iatrogenic injury. The provider has many options available in his armamentarium for resuscitation, but each carries its own risks and benefits. Over the past two decades, trauma research has given us a better understanding of and improved management strategies for this triad. This chapter will explore the various resuscitative options available and summarize the most recent literature regarding their use.