Trauma Hemostasis and Oxygenation Research Network position paper on the role of hypotensive resuscitation as part of remote damage control resuscitation

Thomas Woolley, Patrick Thompson, Emrys Kirkman, Richard Reed, Sylvain Ausset, Andrew Beckett, Christopher Bjerkvig, Andrew P. Cap, Tim Coats, Mitchell Cohen, Marc Despasquale, Warren Dorlac, Heidi Doughty, Richard Dutton, Brian Eastridge, Elon Glassberg, Anthony Hudson, Donald Jenkins, Sean Keenan, Christophe MartinaudEthan Miles, Ernest Moore, Giles Nordmann, Nicolas Prat, Joseph Rappold, Michael C. Reade, Paul Rees, Rory Rickard, Martin Schreiber, Stacy Shackelford, Håkon Skogran Eliassen, Jason Smith, Mike Smith, Philip Spinella, Geir Strandenes, Kevin Ward, Sarah Watts, Nathan White, Steve Williams

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    The Trauma Hemostasis and Oxygenation Research (THOR) Network has developed a consensus statement on the role of permissive hypotension in remote damage control resuscitation (RDCR). A summary of the evidence on permissive hypotension follows the THOR Network position on the topic. In RDCR, the burden of time in the care of the patients suffering from noncompressible hemorrhage affects outcomes. Despite the lack of published evidence, and based on clinical experience and expertise, it is the THOR Network's opinion that the increase in prehospital time leads to an increased burden of shock, which poses a greater risk to the patient than the risk of rebleeding due to slightly increased blood pressure, especially when blood products are available as part of prehospital resuscitation.The THOR Network's consensus statement is, "In a casualty with life-threatening hemorrhage, shock should be reversed as soon as possible using a blood-based HR fluid. Whole blood is preferred to blood components. As a part of this HR, the initial systolic blood pressure target should be 100 mm Hg. In RDCR, it is vital for higher echelon care providers to receive a casualty with sufficient physiologic reserve to survive definitive surgical hemostasis and aggressive resuscitation. The combined use of blood-based resuscitation and limiting systolic blood pressure is believed to be effective in promoting hemostasis and reversing shock".

    Original languageEnglish (US)
    Pages (from-to)S3-S13
    JournalThe journal of trauma and acute care surgery
    Volume84
    Issue number6S Suppl 1
    DOIs
    StatePublished - Jun 1 2018

    Fingerprint

    Hemostasis
    Resuscitation
    Blood Pressure
    Wounds and Injuries
    Research
    Shock
    Hypotension
    Surgical Hemostasis
    Hemorrhage
    Patient Care

    ASJC Scopus subject areas

    • Surgery
    • Critical Care and Intensive Care Medicine

    Cite this

    Trauma Hemostasis and Oxygenation Research Network position paper on the role of hypotensive resuscitation as part of remote damage control resuscitation. / Woolley, Thomas; Thompson, Patrick; Kirkman, Emrys; Reed, Richard; Ausset, Sylvain; Beckett, Andrew; Bjerkvig, Christopher; Cap, Andrew P.; Coats, Tim; Cohen, Mitchell; Despasquale, Marc; Dorlac, Warren; Doughty, Heidi; Dutton, Richard; Eastridge, Brian; Glassberg, Elon; Hudson, Anthony; Jenkins, Donald; Keenan, Sean; Martinaud, Christophe; Miles, Ethan; Moore, Ernest; Nordmann, Giles; Prat, Nicolas; Rappold, Joseph; Reade, Michael C.; Rees, Paul; Rickard, Rory; Schreiber, Martin; Shackelford, Stacy; Skogran Eliassen, Håkon; Smith, Jason; Smith, Mike; Spinella, Philip; Strandenes, Geir; Ward, Kevin; Watts, Sarah; White, Nathan; Williams, Steve.

    In: The journal of trauma and acute care surgery, Vol. 84, No. 6S Suppl 1, 01.06.2018, p. S3-S13.

    Research output: Contribution to journalArticle

    Woolley, T, Thompson, P, Kirkman, E, Reed, R, Ausset, S, Beckett, A, Bjerkvig, C, Cap, AP, Coats, T, Cohen, M, Despasquale, M, Dorlac, W, Doughty, H, Dutton, R, Eastridge, B, Glassberg, E, Hudson, A, Jenkins, D, Keenan, S, Martinaud, C, Miles, E, Moore, E, Nordmann, G, Prat, N, Rappold, J, Reade, MC, Rees, P, Rickard, R, Schreiber, M, Shackelford, S, Skogran Eliassen, H, Smith, J, Smith, M, Spinella, P, Strandenes, G, Ward, K, Watts, S, White, N & Williams, S 2018, 'Trauma Hemostasis and Oxygenation Research Network position paper on the role of hypotensive resuscitation as part of remote damage control resuscitation', The journal of trauma and acute care surgery, vol. 84, no. 6S Suppl 1, pp. S3-S13. https://doi.org/10.1097/TA.0000000000001856
    Woolley, Thomas ; Thompson, Patrick ; Kirkman, Emrys ; Reed, Richard ; Ausset, Sylvain ; Beckett, Andrew ; Bjerkvig, Christopher ; Cap, Andrew P. ; Coats, Tim ; Cohen, Mitchell ; Despasquale, Marc ; Dorlac, Warren ; Doughty, Heidi ; Dutton, Richard ; Eastridge, Brian ; Glassberg, Elon ; Hudson, Anthony ; Jenkins, Donald ; Keenan, Sean ; Martinaud, Christophe ; Miles, Ethan ; Moore, Ernest ; Nordmann, Giles ; Prat, Nicolas ; Rappold, Joseph ; Reade, Michael C. ; Rees, Paul ; Rickard, Rory ; Schreiber, Martin ; Shackelford, Stacy ; Skogran Eliassen, Håkon ; Smith, Jason ; Smith, Mike ; Spinella, Philip ; Strandenes, Geir ; Ward, Kevin ; Watts, Sarah ; White, Nathan ; Williams, Steve. / Trauma Hemostasis and Oxygenation Research Network position paper on the role of hypotensive resuscitation as part of remote damage control resuscitation. In: The journal of trauma and acute care surgery. 2018 ; Vol. 84, No. 6S Suppl 1. pp. S3-S13.
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    abstract = "The Trauma Hemostasis and Oxygenation Research (THOR) Network has developed a consensus statement on the role of permissive hypotension in remote damage control resuscitation (RDCR). A summary of the evidence on permissive hypotension follows the THOR Network position on the topic. In RDCR, the burden of time in the care of the patients suffering from noncompressible hemorrhage affects outcomes. Despite the lack of published evidence, and based on clinical experience and expertise, it is the THOR Network's opinion that the increase in prehospital time leads to an increased burden of shock, which poses a greater risk to the patient than the risk of rebleeding due to slightly increased blood pressure, especially when blood products are available as part of prehospital resuscitation.The THOR Network's consensus statement is, {"}In a casualty with life-threatening hemorrhage, shock should be reversed as soon as possible using a blood-based HR fluid. Whole blood is preferred to blood components. As a part of this HR, the initial systolic blood pressure target should be 100 mm Hg. In RDCR, it is vital for higher echelon care providers to receive a casualty with sufficient physiologic reserve to survive definitive surgical hemostasis and aggressive resuscitation. The combined use of blood-based resuscitation and limiting systolic blood pressure is believed to be effective in promoting hemostasis and reversing shock{"}.",
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    AU - Reed, Richard

    AU - Ausset, Sylvain

    AU - Beckett, Andrew

    AU - Bjerkvig, Christopher

    AU - Cap, Andrew P.

    AU - Coats, Tim

    AU - Cohen, Mitchell

    AU - Despasquale, Marc

    AU - Dorlac, Warren

    AU - Doughty, Heidi

    AU - Dutton, Richard

    AU - Eastridge, Brian

    AU - Glassberg, Elon

    AU - Hudson, Anthony

    AU - Jenkins, Donald

    AU - Keenan, Sean

    AU - Martinaud, Christophe

    AU - Miles, Ethan

    AU - Moore, Ernest

    AU - Nordmann, Giles

    AU - Prat, Nicolas

    AU - Rappold, Joseph

    AU - Reade, Michael C.

    AU - Rees, Paul

    AU - Rickard, Rory

    AU - Schreiber, Martin

    AU - Shackelford, Stacy

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    AU - Smith, Jason

    AU - Smith, Mike

    AU - Spinella, Philip

    AU - Strandenes, Geir

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    AU - Watts, Sarah

    AU - White, Nathan

    AU - Williams, Steve

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