Infusion therapy as an important element of anesthetic strategy for the wounded with hemorrhagic shock

Abstract

Hemorrhagic shock remains the main cause of death of the wounded in all wars and military conflicts. A key aspect in modern anesthetic strategy for the wounded with hemorrhagic shock is the strategy of a balanced infusion therapy. It consists in restricting the infusion of crystalloids and colloids and the earliest possible transfusion of blood products to a wounded person with massive hemorrhage. Currently, the main option for blood transfusion both in civilian health care facilities and in medical facilities of the Armed Forces of Ukraine is the use of the so-called component blood transfusion therapy, i.e. transfusion of packed red blood cells and fresh-frozen plasma. This approach is absolutely justified for elective surgical and somatic patients, but has a number of significant disadvantages in the treatment of wounded with massive hemorrhage. In addition, blood transfusion in the conditions of hostilities, disasters and emergency situations has additional logistical (quick availability) and safety (risk of errors when combining blood groups) requirements for blood preparations. Therefore, the issue of alternative, relative to component therapy, variants of transfusion therapy in the treatment of hemorrhagic shock becomes especially relevant.