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Table 2 Summary of the clinical trials for permissive hypotension/hypotensive resuscitation and restricted/controlled resuscitation

From: Permissive hypotension/hypotensive resuscitation and restricted/controlled resuscitation in patients with severe trauma

Type of resuscitation strategy Authors Study design Patients Interventions Control Primary outcome Secondary outcome/sub-analysis Outcome for coagulations Major limitations
Permissive hypotension,
Hypotensive resuscitation
Dutton et al. 2002 RCT With traumatic injury, ongoing hemorrhage, and had a SBP <90 mmHg Fluid administration titrated to SBP of 70 mmHg Fluid administration titrated to SBP of 100 mmHg The overall survival rate did not differ N.A. N.A. The mean age was 31, excluding patients older than 55 and medical history of diabetes or coronary artery disease
Morrison et al. 2011 RCT Undergoing emergency laparotomy or thoracotomy for trauma, who had SBP ≤90 mmHg Fluid administration titrated to MAP of 50 mmHg Fluid administration titrated to MAP of 65 mmHg 30-day mortality did not differ Mortality in the early postoperative period was decreased, and received blood products were fewer Immediate postoperative coagulopathy was less Patients older than 45 years were excluded. 93% were penetrating injury
Restricted resuscitation,
Controlled resuscitation
Brown et al. 2013 Post hoc analysis With blunt injury, out-of-hospital SBP ≤90 mmHg, and ISS >15 Pre-hospital crystalloid resuscitation, ≤500 ml Pre-hospital crystalloid resuscitation, >500 ml 30-day in-hospital mortality did not differ Without pre-hospital hypotension, control group was associated with an increased risk of mortality Without pre-hospital hypotension, control group was associated with an increased risk of acute coagulopathy Post hoc analysis, only blunt trauma
Schreiber et al. 2015 RCT With blunt or penetrating injury and out-of-hospital SBP ≤90 mmHg 250 mL of fluid as an initial bolus, additional fluid to maintain an SBP of 70 mmHg 2 L of fluid as an initial bolus, additional fluid to maintain an SBP of 110 mmHg The mean crystalloid volume administered was less 24-h mortality was decreased in patients with blunt trauma Coagulation values at the emergency department did not differ Feasibility and pilot study
  1. Patients with traumatic brain injury were excluded in all of four trials
  2. RCT randomized controlled trial, SBP systolic blood pressure, N.A. not applicable, MAP mean blood pressure, ISS injury severity score