SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2018
Permissive hypotensive resuscitation in adult patients with traumatic haemorrhagic shock: a systematic review.
Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- 2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 8. Pediatric advanced life support.Clinical and experimental emergency medicine · 2026Guideline
- The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition.Critical care (London, England) · 2023Guideline
- Cellular and Molecular Mechanisms of Hemorrhagic Shock: Biological Rationale for Individualized Fluid Resuscitation Strategies and Multimodal Monitoring.Biomedicines · 2026Review
- Perioperative Patient Blood Management: Evidence-Based Strategies for Surgeons and Anesthesiologists: A Narrative Review.Journal of clinical medicine · 2026Review
- Key strategies in trauma anesthesia for severe hemorrhage: a narrative review.Korean journal of anesthesiology · 2026Review
- Bimodal distribution of trauma-related acute kidney injury (TrAKI): A clinical review.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Review
- Implementation status of European guidelines on trauma management of prehospital bleeding control: a national survey in Austria.BMC emergency medicine · 2025Article
- Permissive strategies in intensive care units (ICUs): actual trends?Anesthesia and pain medicine · 2025Article
- Blood Pressure Prediction During Blood Transfusion: A Population-Informed Multi-Modal Sequential Inference Approach.IEEE control systems letters · 2025Article
- Are crystalloid-based fluid expansion strategies still relevant in the first hours of trauma induced hemorrhagic shock?Critical care (London, England) · 2024Review
- Sudden-Onset Disaster Mass-Casualty Incident Response: A Modified Delphi Study on Triage, Prehospital Life Support, and Processes.Prehospital and disaster medicine · 2023Review
- Influence of blood hemodynamics on the treatment outcomes of limited fluid resuscitation in emergency patients with traumatic hemorrhagic shock.Clinics (Sao Paulo, Brazil) · 2023Article
- Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuries.Critical care (London, England) · 2022Review
- Endothelial Glycocalyx Degradation in Critical Illness and Injury.Frontiers in medicine · 2022Review
- Hydroxyethyl Starch Improves the Prognosis of Rats with Traumatic Shock via Activation of the ERK Signaling Pathway in Lymphocytes.Computational and mathematical methods in medicine · 2022Article
- The effect of targeting Tie2 on hemorrhagic shock-induced renal perfusion disturbances in rats.Intensive care medicine experimental · 2021Article
- Article
- Evaluation and management of haemorrhagic shock in polytrauma: Clinical practice guidelines.Journal of clinical orthopaedics and trauma · 2021Article
- Endothelial cell-derived SSAO can increase MLCOpen life sciences · 2021Article
- [Paediatric Life Support].Notfall & rettungsmedizin · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPermissive hypotensive resuscitation (PHR) is an advancing concept aiming towards deliberative balanced resuscitation whilst treating severely injured patients, and its effectiveness on the survival rate remains unexplored. This detailed systematic review aims to critically evaluate the available literature that investigates the effects of PHR on survival rate.
methodsA systematic review design searched for comparative and non-comparative studies using EMBASE, MEDLINE, PubMed, Web-of-Science and CENTRAL. Full-text articles on adult trauma patients with low blood pressure were considered for inclusion. The risk of bias and a critical appraisal of the identified articles were performed to assess the quality of the selected studies. Included studies were sorted into comparative and non-comparative studies to ease the process of analysis. Mortality rates of PHR were calculated for both groups of studies.
resultsFrom the 869 articles that were initially identified, ten studies were selected for review, including randomised control trials (RCTs) and cohort studies. By applying the risk of bias assessment and critique tools, the methodologies of the selected articles ranged from moderate to high quality. The mortality rates among patients resuscitated with low volume and large volume in the selected RCTs were 21.5% (123/570) and 28.6% (168/587) respectively, whilst the total mortality rate of the patients enrolled in three non-comparative studies was 9.97% (279/2797).
conclusionsThe death rate amongst post-trauma patients managed with conservative resuscitation was lower than standard aggressive resuscitation, which indicates that PHR can create better survival rate among traumatised patients. Therefore, PHR is a feasible and safely practiced fluid resuscitative strategy to manage haemorrhagic shock in pre-hospital and in-hospital settings. Further trials on PHR are required to assess its effectiveness on the survival rate. LEVEL OF EVIDENCE: Systematic review, level III.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.