Butler Frank K
Committee on Tactical Combat Casualty Care, Joint Trauma System, US Army Institute of Surgical Research, San Antonio, TX.
Wilderness Environ Med. 2017 Jun;28(2S):S74-S81. doi: 10.1016/j.wem.2016.12.007.
The prevailing wisdom for the prehospital fluid resuscitation of trauma victims in hemorrhagic shock in 1992 was to administer 2 L of crystalloid solution as rapidly as possible. A review of the fluid resuscitation literature found that this recommendation was not well supported by the evidence at the time. Prehospital fluid resuscitation strategies were reevaluated in the 1993-1996 Tactical Combat Casualty Care (TCCC) research program. This article reviews the advances in prehospital fluid resuscitation as recommended by the original TCCC Guidelines and modified over the following 2 decades. These advances include hypotensive resuscitation, use of prehospital whole blood or blood components when feasible, and use of Hextend or selected crystalloids when logistical considerations make blood or blood component use not feasible.
1992年，对于出血性休克创伤患者的院前液体复苏，当时普遍的做法是尽快输注2升晶体溶液。对液体复苏文献的回顾发现，这一建议当时并没有得到充分的证据支持。1993 - 1996年战术战斗伤救治（TCCC）研究项目对院前液体复苏策略进行了重新评估。本文回顾了最初的TCCC指南所推荐的、并在随后20年里经过修订的院前液体复苏进展。这些进展包括低血压复苏、在可行时使用院前全血或血液成分，以及在后勤因素使得血液或血液成分使用不可行时使用贺斯（Hextend）或特定的晶体液。
