ArticleInjury2025
A contemporary analysis of prehospital crystalloid resuscitation after trauma.
Article in Injury, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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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
1 citing paper in PubMed.
- Plasma Regulates Homeostatic Pulmonary Endothelial Signaling to Mitigate Vascular Leak Following Polytrauma and Hemorrhagic Shock.Shock (Augusta, Ga.) · 2026Article
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Authors and funding
5 authors.
Funding
Abstract
introductionMinimizing crystalloid administration to hemorrhaging trauma patients has been shown to decrease morbidity and mortality. Iatrogenic harm from 'over-resuscitation' may be a concern for trauma patients undergoing prolonged EMS transport. Our primary objective was to quantify the volume of prehospital crystalloid administered to hypotensive trauma patients with at least 30 min of exposure to prehospital care for whom fluid administration was not indicated in the intervention arm of prior randomized trials of fluid restriction. In addition, we aimed to identify factors associated with crystalloid administration and determine if trends in administration were present across the study period. STUDY
designThe ESO Data Collaborative 2018-2022 annual datasets were used for this study. Trauma patients who received prehospital vascular access, had a minimum systolic blood pressure between 75 and 90 mmHg, a GCS ≥ 14, and were exposed to EMS care for >30 min (on-scene to destination arrival interval) were evaluated for inclusion. The primary outcome for this analysis was the documented volume of crystalloid administration. Logistic regression modeling was used to investigate factors associated with the administration of >500 mL of crystalloid.
resultsAfter application of exclusion criteria, 26,447 patients treated by 1150 EMS agencies were evaluated. Patients received a median of 200 [10,500] mL of fluid in the prehospital setting, and 95 % of patients received <1010 mL. Overall, 5745 (21.7 %) patients received >500 mL of fluid. Factors associated with administration of >500 mL of fluid included increased 'EMS exposure' time (OR 1.01 [1.01, 1.01] per minute), IV cannula size (22 G OR: 0.5 [0.4, 0.6], 20 G OR: [reference], 18 G OR: 2.1 [2.0, 2.3], 16 G OR: 4.6 [4.1, 5.2]), age (0.996 [0.994, 0.997]) per year, female sex (0.72 [0.68, 0.77]), minimum SBP (0.95 [0.94, 0.96] per mmHg), and penetrating injury, (1.9 [1.7, 2.1]).
conclusionOverall, crystalloid volumes administered in the prehospital setting were low in this cohort of hypotensive trauma patients exposed to at least 30 min of prehospital care. This may suggest that the practice of fluid restriction for patients who are hypotensive following trauma has permeated into EMS practice nationwide.
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