The primary objective of trauma care is to minimise or reverse shock thus saving life. Aggressive fluid resuscitation may be harmful in these patients because the resulting increased blood pressure and circulating volume may cause clot disruption, dilution of clotting factors and/or the reversal of the body's natural response to haemorrhage. The concept of hypotensive resuscitation has evolved where small aliquots of fluid are infused, with hypovolaemia and hypotension tolerated as a necessary evil until definitive haemorrhage control can be achieved. This review outlines the animal and human data to support the strategy of hypotensive resuscitation.
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