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Consensus must be found on intravenous fluid therapy management in trauma patients
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Advisor(s)
Abstract(s)
Introduction: Trauma is an important cause of death among young people and
30-40% of this mortality rate is due to hypovolemic shock, intensified by trauma’s
lethal triad: Hypothermia, Acidosis, and Coagulopathy. Nurses are responsible for
managing fluid therapy administration in trauma victims. The purpose of this study
is to analyse the reasons why intravenous fluid therapy is recommended for trauma
patients’ hemodynamic stabilization.
Methods: This narrative literature review included published and unpublished studies
in English, Spanish or Portuguese between 1994 and January 2019. The search
results were analyzed by two independent reviewers. Inclusion criteria encompasses
quantitative studies involving trauma victims aged over 18 who underwent fluid
therapy in a prehospital assessment context.
Results& Discussion: 11 quantitative studies were included. 9 involved the use of
fluid therapy for hypotension treatment and 2 of the studies analyzed involved the
use of warmed fluid therapy for hypothermia treatment. The analysis performed
reveals that the administration of aggressive fluid therapy seems to be responsible
for the worsening of the lethal triad. In the presence of traumatic brain injury, permissive
hypotension is not allowed due to the negative impact on cerebral perfusion
pressure. Used as warming measure, warmed fluid therapy does not seem to have a
significant impact on body temperature.
Conclusions: There is no consensus regarding the administration of fluid therapy
to trauma patients. This conclusion clearly supports the need to develop more randomized
controlled trials in order to understand the effectiveness of such measure
when it comes to control hypovolemia and hypothermia.
Description
Keywords
Trauma Fluid Therapy Hypotermia Hypotension
Citation
Mota, M., Reis Santos, M., Cunha, M., Melo, F., Neves, H., Abrantes, T. Consensus must be found on intravenous fluid therapy management in trauma patients. Suplemento digital Rev ROL Enferm 2020; 43(1): 374-379