Permissive Hypotension vs. Conventional Resuscitation in Patients With Trauma or Hemorrhagic Shock: A Review

Trauma is one of the leading causes of death, with hemorrhage being one of the most preventable aspects. Aggressive fluid resuscitation protocols were implemented before their value was critically evaluated. Permissive hypotension limits blood loss while maintaining adequate perfusion and positively impacts outcomes in actively hemorrhaging trauma patients. Peer-reviewed articles pertaining to the use of hypotensive resuscitation were identified and selected from a search of the PubMed database. Based on this, seven primary research articles were selected for evaluation. The articles were grouped based on their approach to hypotensive resuscitation. We focused on the safety and viability of hypotensive resuscitation, compared it to normotensive resuscitation, and compared mortality rates. Our review shows that hypotensive resuscitation is safe and has a decreased mortality rate when compared to normotensive resuscitation in hemorrhagic shock patients. There is less blood loss, hemodilution, ischemia, and hypoxia in tissues. Additional research is required to determine the exact parameters that are most beneficial in different patient populations.