• D T Martin and M A Schreiber.
• Division of Trauma, Critical Care, and Acute Care Surgery, Department of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mail Code L-611, Portland, OR, 97239, USA. martida@ohsu.edu.
• Eur J Trauma Emerg Surg. 2014 Dec 1; 40 (6): 641-56.

PurposeMortality rates among the severely injured remain high. The successful treatment of hemorrhagic shock relies on expeditious control of bleeding through surgical ligation, packing, or endovascular techniques. An important secondary concern in hemorrhaging patients is how to respond to the lost blood volume. A single method that is able to adequately address all needs of the exsanguinating patient has not yet been agreed upon, despite a large growth of knowledge regarding the causative factors of traumatic shock.MethodsA review of relevent literature was performed.ConclusionsMany different trials are currently underway to discriminate ways to improve outcomes in the severely injured and bleeding patient.  This paper will review: (1) recent advances in our understanding of the effects hemorrhagic shock has on the coagulation cascade and vascular endothelium, (2) recent research findings that have changed resuscitation, and (3) resuscitation strategies that are not widely used but under active investigation.

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