REDUCED PLASMA ONCOTIC PRESSURE IS INDICATIVE OF INJURY SEVERITY IN TRAUMA PATIENTS

摘要

Trauma is the leading cause of death in people aged 1-44 years old, with hemorrhagic shock accounting for nearly half of these deaths. These fatalities often occur early, within 24 hours, but many are deemed potentially preventable with appropriate resuscitation. The term "appropriate resuscitation" is somewhat ambiguous and subjective because of the lack of a standardized resuscitation protocol. We attribute this deficiency to our rudimentary understanding of the mechanisms of hemorrhagic shock and resuscitation. Shock is defined as the inadequate delivery of oxygen to tissues leading to cellular dysfunction and injury. However, current resuscitation methods are often a restoration of systemic blood pressure in large vessels, and not targeted towards restoring microcirculatory flow and/or normal function at the cellular level. In order to develop a standardized resuscitation protocol for hemorrhagic shock, we must develop a comprehensive understanding of the vascular, endothelial, and fluid mechanic changes in the progression of shock as well as the effect of resuscitative fluids on fluid balance.