controversies in contemporary trauma resuscitation

Controversies in Controversies in Contemporary Trauma Contemporary Trauma

ResuscitationResuscitation

Ronald V. Maier, M.D., F.A.C.S.Ronald V. Maier, M.D., F.A.C.S.

Ernest E. Moore, M.D., F.A.C.S.Ernest E. Moore, M.D., F.A.C.S.

Hypotensive Hypotensive ResuscitationResuscitation

4

J Trauma, Oct 2008

Controversial PeopleControversial People

John Holcomb, MDJohn Holcomb, MD2009 Memorial Trauma Symposium 2009 Memorial Trauma Symposium

Keynote SpeakerKeynote Speaker

1:1:1 Component Therapy

Component Therapy:1U PRBC + 1U PLT + 1U FFP + 1 U cryo 680 COLDCOLD mL

•Hct 29%•Plt 80K•Coag factors 65% of initial concentration

•1000 mg Fibrinogen

WWB:WWB:

500 mL 500 mL WarmWarm

Hct: 38-50%Hct: 38-50%

Plt: 150-400KPlt: 150-400K

Coag: 100%Coag: 100%

1000 mg Fibrinogen1000 mg Fibrinogen•Armand & Hess, Transfusion Med. Rev., 2003

TourniquetsTourniquets

Bystander Tourniquets Bystander Tourniquets

Pelvic Packing

The Impact ofThe Impact of Hypertonic Hypertonic Saline Resuscitation Saline Resuscitation on the on the Gene Expression Profile of Gene Expression Profile of Critically Injured PatientsCritically Injured Patients

Ang DN, Maier RVAng DN, Maier RV

Endovascular Repair of Endovascular Repair of Vascular InjuriesVascular Injuries

Vertebral Artery injuriesVertebral Artery injuries BluntBlunt PenetratingPenetrating