ABSTRACT
This chapter addresses several fundamental questions related to the resuscitation of the trauma patient within an evidence-based construct. The particular questions are important; however, they do not represent all possible resuscitation-related dilemmas that may confront the surgeon or clinician. The goal, therefore, is to demonstrate and differentiate those maneuvers that are based on scientific evidence and discriminate them from those based solely on historical opinion. This is not to say that our surgical forefathers were wrong in their approaches (because in many cases, they were right on target), but to simply articulate those therapies that have a scientific basis from those whose basis should be questioned and improved upon if shown to be false. Acute-phase trauma resuscitation may be conducted safely with any isotonic crystalloid, as well as hypertonic saline, but not colloids. In general, crystalloid solutions remain preferred because of their low cost and similar outcomes compared to colloids.
