ViewpointIs the normalisation of blood pressure in bleeding trauma patients harmful?
Section snippets
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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