Elsevier

The Lancet

Volume 357, Issue 9253, 3 February 2001, Pages 385-387
The Lancet

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Is the normalisation of blood pressure in bleeding trauma patients harmful?

https://doi.org/10.1016/S0140-6736(00)03653-9Get rights and content

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Evidence from systematic reviews

Medical anti-shock trousers (MAST) provides external pneumatic compression of the legs and was first used in the Vietnam war to stabilise patients with haemorrhagic shock during transportation. After the war, MAST was widely used in the care of bleeding trauma patients. MAST increases blood pressure by compressing blood vessels in the legs thus raising systemic vascular resistance, and by shunting blood from the lower body to the brain, heart, and lungs.5 The hope was that by increasing venous

Conclusions

The use of MAST, early fluid administration, and colloid resuscitation is based on the idea that raising blood pressure in bleeding trauma patients will maintain tissue perfusion and so prevent haemorrhagic shock and its consequences. However, there is no unbiased evidence that any of these strategies improve survival, and there is a suggestion that they are harmful. Taken together, evidence from systematic reviews calls into question resuscitation protocols, such as the advanced trauma life

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