？Reanimación agresiva o hipotensión permisiva? Rompiendo paradigmas en trauma

in the last few years multiple trauma victims found to be hypotense, have been subejct to agresive resuscitation with cristaloids until normotension is achieved before proceeding with the surgical management. this have made the preoperative mortality in trauma remain unchanged, being the secondary acute anemia the responsible for this fatal outcome. the normal physiologic sympathetic response aims to stop the bleeding while mantaining adecuate perfusion to vital organs. the agressive reanimation promotes the continuous bleeding by breaking the newly formed immature clot and by interrupting the normal vasomotor response of the vacular tree, leading to an increased morbidity and mortality. up today, most of the animal studies and the few already conducted in human subjects, have shown that the hypotensive reanimation, wich consists in infusing cristaloids only to reach a sistolic blood pressure of 60-70mmhg (palpable central pulses),constitutes a reliable therapeutic regime that allows an increased number of patients to be conducted to the operating room to control bleeding and do the definitive treatment, which is the main goal in the patient affected by trauma.