Resuscitation of Traumatic Hemorrhagic Shock

Trauma is an important cause of mortality worldwide and hemorrhage remains a major cause of potentially preventable deaths after injury. Coagulopathy that is intrinsic to trauma along with the complications of aggressive fluid resuscitation to restore circulatory volume perpetuates further bleeding. In patients with severe injuries, appropriate hemostatic resuscitation in addition to damage control interventions such as surgery, is vital to break the vicious cycle of coagulopathy, restore tissue perfusion and improve survival. The concept of hemostatic strategies in trauma is constantly evolving. The goal of resuscitation practices is to mimic the functionality of whole blood and to restore normal physiology. In this review, we briefly discuss the physiology of coagulopathy in trauma and delve into the hemostatic resuscitation practices with blood, blood products and adjuncts.