Permissive hypotension

Permissive Hypotension is a medical strategy used in certain emergency situations, such as trauma or hemorrhagic shock, where the blood pressure is allowed to drop to a certain level before intervention is initiated. This approach is used to prevent further bleeding and to buy time until definitive surgical control of the bleeding can be achieved.

Overview

Permissive hypotension, also known as hypotensive resuscitation, is a concept that has been used in the management of hemorrhagic shock for many years. The strategy involves allowing the systolic blood pressure to drop to a level of 80-90 mmHg before initiating aggressive fluid resuscitation. This approach is thought to reduce the risk of dislodging blood clots and exacerbating bleeding.

Indications

Permissive hypotension is typically used in the management of patients with trauma and uncontrolled hemorrhage. It may also be used in patients with ruptured abdominal aortic aneurysm or other forms of vascular trauma.

Contraindications

Permissive hypotension is contraindicated in patients with traumatic brain injury as it may lead to inadequate cerebral perfusion. It is also contraindicated in patients with pre-existing hypertension as these patients may require higher blood pressures to maintain adequate organ perfusion.

Risks and Complications

Potential risks and complications of permissive hypotension include organ failure due to inadequate perfusion, coagulopathy due to dilution of clotting factors, and hypothermia due to the use of cold resuscitation fluids.

See Also

• Hypotension
• Hemorrhagic shock
• Trauma
• Ruptured abdominal aortic aneurysm
• Vascular trauma

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