- Is a resuscitation strategy in catastrophic bleeding in which the aim is not to normalise haemodynamic parameters but to obtain minimal levels of perfusion prior to a definitive intervention to arrest bleeding followed by complete fluid resuscitation
- the aim is to prevent disruption of clot, dilutional coagulopathy and further bleeding (see the Lethal Triad)
- it is mainly applicable in adequately resourced health systems where timely intervention can occur from onset of haemorrhage
- Examples – Severe Trauma (especially penetrating truncal trauma), Ruptured abdominal aortic aneurysm, Severe upper GI bleeding
- Controversy surrounds the precise indications and acceptable limits of hypotension or perfusion
Further reading