Surgery, gynecology & obstetrics
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Victims of penetrating trauma often arrive at a trauma center within minutes of sustaining their injury but nevertheless are in a state of deep circulatory shock. Such patients require extensive resuscitative efforts; in particular, some benefit from rapid, massive normothermic fluid resuscitation. During an initial one year period, 153 of 730 patients required immediate operation and, of these, 33 required rapid infusion defined as greater than 5 liters per hour during the first hour. ⋯ There was a statistically significant improvement in clinical flow rates, decrement in resuscitation times and unexpected survival. In particular, the latter group (nine survivors) included four who were clinically dead in the field or on arrival at the trauma center, or both. Rapid infusion of normothermic fluids may be of benefit not only in penetrating trauma but also more generally in the management of massive hemorrhage.