Intraoperative Hypotensive Resuscitation
Aug 02, 2016•52 min
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Summary
Drs. Matthew Carrick and Kenneth Mattox delve into their randomized prospective clinical trial on intraoperative hypotensive resuscitation, highlighting its historical context, complex design, and the challenges of conducting such research with exception from informed consent. They explore the study's results, which, despite early termination and lack of statistical significance, have clinically influenced trauma practice. The discussion extends to challenging traditional "sacred cows" in resuscitation, including fluid management in the ICU, the use of REBOA, and potential applications in TBI patients, urging future research to continue pushing the boundaries of clinical science.Episode description
In this episode, we discuss an interesting study which was recently published in the Journal of Trauma and Acute Care Surgery (see link below) with the study’s lead author, Dr. Matthew Carrick, and the senior author, Dr. Kenneth Mattox. Drs. Carrick and Mattox describe the extension of the hypotensive resuscitation paradigm beyond the trauma bay and into the operating room, as well as some details about how they were able to accomplish this prospective, randomized trial with exception from informed consent. In characteristic form, Dr. Mattox also challenges the audience to take on more areas of untested dogma — what he calls the “sacred cows” of patient care — and to make an impact in clinical science research.Article ReferencedCarrick MM, Morrison CA, Tapia NM, Leonard J, Suliburk JW, Norman MA, Welsh FJ, Scott BG, Liscum KR, Raty SR, Wall MJ Jr, Mattox KL. Intraoperative hypotensive resuscitation for patients undergoing laparotomy or thoracotomy for trauma: Early termination of a randomized prospective clinical trial. J Trauma Acute Care Surg. 2016 Jun;80(6):886-96.http://www.ncbi.nlm.nih.gov/pubmed/27015578
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