Endpoints for fluid resuscitation in hemorrhagic shock

Vigorous intravenous fluid resuscitation has become widely accepted as the optimum management of hemorrhagic shock in trauma. There is now, however, sufficient evidence for this position to be reviewed. Hypotensive or delayed resuscitation has been postulated as a means by which the mortality associated with treatment can be reduced. It has been suggested that overresuscitation with intravenous fluids may worsen hemorrhage. This article discusses the possible adverse effects of "conventional" resuscitation and examines the evidence to support alternative treatment modalities.