Hemorrhage replacement options other than blood

Our team of trauma and critical care clinicians will summarize the available evidence as it relates to: albumin, ALM, vasopressors, and synthetic blood. Since the publication of the SAFE study, there has been hesitancy in the trauma community for use of albumin, however there has been increased interest recently in such fields as burn resuscitation to use albumin. Colloids in general, such as hextend, have equally fallen out of favor for their association with kidney injuries. Attempts at finding optimal dosing of ALM formulations have led to mixed results in multiple recent studies. Vasopressor use in trauma patients has recently experienced a resurgence at several academic centers and the underlying pathophysiology supporting their use, as well as recent studies, will be reviewed. Options for synthetic blood and future use cases will also be discussed.