Timing of major fracture care in polytrauma patients - An update on principles, parameters and strategies for 2020.

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Abstract

[Indexed for MEDLINE] 6. Scand J Trauma Resusc Emerg Med. 2019 Feb 12;27(1):14. doi: 10.1186/s13049-019-0595-5. Permissive hypotensive resuscitation in patients with traumatic hemorrhagic shock. Ho KH(1), Tarng YW(2), Chou YP(3)(4)(5), Lin HL(6). Author information: (1)Division of Trauma Surgery, Department of Emergency, Kaohsiung Veterans General Hospital, 386, Da-Chung 1st Road, Kaohsiung, 813, Taiwan. (2)Department of Orthopaedic, Kaohsiung Veterans General Hospital, 386, Da-Chung 1st Road, Kaohsiung, Taiwan. (3)Division of Trauma Surgery, Department of Emergency, Kaohsiung Veterans General Hospital, 386, Da-Chung 1st Road, Kaohsiung, 813, Taiwan. chou2763e@yahoo.com.tw. (4)Division of Thoracic Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, 386, Da-Chung 1st Road, Kaohsiung, Taiwan. chou2763e@yahoo.com.tw. (5)Department of Cosmetic Science, College of Human Ecology, Chang Gung University of Science and Technology, Kweishan, Taoyuan, Taiwan. chou2763e@yahoo.com.tw. (6)Division of Acute Care Surgery, Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, 386, Da-Chung 1st Road, Kaohsiung City, 813, Taiwan. hsinglin2002@yahoo.com.tw. Comment on Scand J Trauma Resusc Emerg Med. 2018 Dec 17;26(1):107. doi: 10.1186/s13049-018-0572-4. We read the article "Risks and benefits of hypotensive resuscitation in patients with traumatic hemorrhagic shock: a meta-analysis" by Natthida Owattanapanich et al. with great interest and found it to be insightful. In our commentary, we propose possible reasons why mortality was lower in the permissive hypotension group and how the need for blood transfusion decreased in this group. No significant difference in acute kidney injury (AKI) was evident among patient groups, possibly because all these patients might have AKI. However, we do agree that permissive hypotension is of considerable benefit to trauma patients and worth further study. DOI: 10.1186/s13049-019-0595-5 PMCID: PMC6373084