Skip to content

Research at St Andrews

Trauma Hemostasis and Oxygenation Research Network position paper on the role of hypotensive resuscitation as part of remote damage control resuscitation

Research output: Contribution to journalArticlepeer-review


Thomas Woolley, Patrick Thompson, Emrys Kirkman, Richard Reed, Sylvain Ausset, Andrew Beckett, Christopher Bjerkvig, Andrew Cap, Tim Coats, Mitchell Cohen, Marc Despasquale, Warren Dorlac, Heidi Doughty, Richard Dutton, Brian Eastridge, Elon Glassberg, Anthony Hudson, Donald Jenkins, Sean Keenan, Christophe Martinaud & 19 more Ethan Miles, Ernest Moore, Giles Nordmann, Nicolas Prat, Joseph Rappold, Michael C. Reade, Paul Rees, Rory Rickard, Martin Schreiber, Stacy Shackelford, Håkon Skogran Eliassen, Jason Smith, Mike Smith, Philip Spinella, Geir Strandenes, Kevin Ward, Sarah Watts, Nathan White, Steve Williams

School/Research organisations


The Trauma Hemostasis and Oxygenation Research (THOR) Network has developed a consensus statement on the role of permissive hypotension in remote damage control resuscitation (RDCR). A summary of the evidence on permissive hypotension follows the THOR Network position on the topic. In RDCR, the burden of time in the care of the patients suffering from noncompressible hemorrhage affects outcomes. Despite the lack of published evidence, and based on clinical experience and expertise, it is the THOR Network’s opinion that the increase in prehospital time leads to an increased burden of shock, which poses a greater risk to the patient than the risk of rebleeding due to slightly increased blood pressure, especially when blood products are available as part of prehospital resuscitation.

The THOR Network’s consensus statement is, “In a casualty with life-threatening hemorrhage, shock should be reversed as soon as possible using a blood-based HR fluid. Whole blood is preferred to blood components. As a part of this HR, the initial systolic blood pressure target should be 100 mm Hg. In RDCR, it is vital for higher echelon care providers to receive a casualty with sufficient physiologic reserve to survive definitive surgical hemostasis and aggressive resuscitation. The combined use of blood-based resuscitation and limiting systolic blood pressure is believed to be effective in promoting hemostasis and reversing shock”


Original languageEnglish
Pages (from-to)S3-S13
JournalThe Journal of Trauma Acute Care Surgery
Issue number6S
Early online date27 Feb 2018
Publication statusPublished - Jun 2018
EventTHOR Network 2017 Remote Damage Control Resuscitation System Symposium - Os, Norway
Duration: 26 Jun 201728 Jun 2017

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. The REBOA window: a cadaveric study delineating the optimum site for austere cannulation of the femoral artery for resuscitative endovascular balloon occlusion of the aorta

    Slim, N., West, C. T., Rees, P., Brassett, C. & Gaunt, M., 2 Mar 2020, In: BMJ Military Health.

    Research output: Contribution to journalArticlepeer-review

  2. 43 The role of mechanically-supported emergency percutaneous coronary intervention in cardiogenic shock

    Frain, K. & Rees, P., 2020, In: Heart. 106, Suppl 2, p. A36-A36

    Research output: Contribution to journalArticlepeer-review

  3. Military application of mechanical CPR devices: a pressing requirement?

    Parsons, I. T., Cox, A. T. & Rees, P., Nov 2018, In: Journal of the Royal Army Medical Corps. 164, 6, p. 438-441

    Research output: Contribution to journalArticlepeer-review

  4. An observational study of clinical outcomes of everolimus-eluting bioresorbable scaffolds comparing the procedural use of optical coherence tomography against angiography alone

    Hamshere, S., Byrne, A., Guttmann, O., Rees, P., Weerakody, C., Wragg, A., Knight, C., Mathur, A. & Jones, D. A., 1 Sep 2018, In: Coronary Artery Disease. 29, 6, p. 482-488

    Research output: Contribution to journalArticlepeer-review

ID: 255979913