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Hypotensive resuscitation is a strategy used in patients with uncontrolled internal hemorrhage, but does it decrease mortality? To compare different fluid administration strategies in trauma patients, researchers performed a meta-analysis of four randomized controlled trials (RCTs) involving 2107 patients and seven observational studies involving 13,687 patients.
One of the RCTs was excluded from the final analysis because it had a high protocol-violation rate and markedly different study population. Compared with restricted fluid resuscitation, liberal fluid resuscitation was associated with higher overall mortality in both the RCTs (risk ratio, 1.25) and the observational studies (odds ratio, 1.14). The authors caution that most of the stu…