Resuscitation of the trauma patient: restoration of hemodynamic functions using clinical algorithms

Two algorithms were developed for immediate fluid resuscitation and subsequent management of emergency trauma patients and critically ill postoperative patients. These algorithms were developed from decision rules based on objective physiologic values attained in patients surviving life-threatening shock and trauma. The improved mortality in prospective studies of these two algorithms supports the hypothesis that compensatory physiologic responses of survivors of life-threatening acute illness are major determinants of outcome. Therapy that supports these compensations and produces the survivor pattern was found to improve survival rates and reduce post-resuscitation complications. These prospective studies confirm the validity of an organized, coherent physiologic approach that has as its goal the achievement of optimal physiologic patterns in contrast to simple restoration of hemodynamic and chemical abnormalities to the normal range, as has been the endpoint of the traditional approach.