Severity of hemorrhage and rate of bleeding are fundamental factors in the outcomes of trauma. Intravenous
administration of fluid is the basic treatment to maintain blood pressure until bleeding is controlled.
The main guideline, used almost worldwide, Advanced Trauma Life Support, established by the
American College of Surgeons in 1976, calls for aggressive administration of intravenous fluids, primarily
crystalloid solutions. Several other guidelines, such as Prehospital Trauma Life Support, Trauma Evaluation
and Management, and Advanced Trauma Operative Management, are applied according to a patient’s
current condition. However, the ideal strategy remains unclear. With permissive hypotension, also known
as hypotensive resuscitation, fluid administration is less aggressive. The available models of permissive
hypotension are based on hypotheses in hypovolemic physiology and restricted clinical trials in animals.
Before these models can be used in patients, randomized, controlled clinical trials are necessary. (Critical
Care Nurse. 2013;33[6]:18-25)