Emerging therapies in traumatic hemorrhage control

Purpose of review: Care of the injured patient is a dynamic process. Hemorrhage remains the primary cause of preventable death after trauma. Rapid and effective early care can improve survival and outcomes. Emerging therapies to address traumatic hemorrhage will be discussed. Recent findings: Current concepts in trauma care include damage control resuscitation with rapid surgical correction of bleeding; prevention of the development of the lethal triad; limitation of crystalloid administration and application of high ratios of plasma and platelets to packed red blood cells. Prehospital resuscitation strategies can effect care of the hemorrhaging trauma patient, as well. The goal should be to preserve vital functions without increasing the risk for further bleeding. The concept of hypotensive resuscitation has been formulated to address this issue. The type of resuscitation fluid also plays an important role, with novel fluids currently being studied for routine use. Compressible hemorrhage constitutes an important component of potentially survivable injury. Hemostatic dressings and tourniquets can prove essential to the management of combat and civilian wounds. Summary: Given the potential to preserve life with appropriate attention applied to the bleeding trauma victim, it is vitally important to explore the options currently available and continue to make improvements in care.