In damage control resuscitation for major haemorrhage following polytrauma, the concept of permissive hypotension targets which systolic blood pressure in patients WITHOUT traumatic brain injury?
- A 100–110 mmHg
- B 60–70 mmHg
- C 80–90 mmHg ✓
- D Normal systolic pressure >120 mmHg should be maintained
Correct answer: C. 80–90 mmHg
Explanation
Permissive hypotension (hypotensive resuscitation) deliberately maintains a lower-than-normal systolic blood pressure (80–90 mmHg, or MAP 50–65 mmHg) in penetrating or blunt trauma without TBI to reduce hydraulic disruption of forming clots and limit coagulopathy from excessive crystalloid use. In patients with traumatic brain injury, permissive hypotension is contraindicated as adequate cerebral perfusion pressure must be maintained (target SBP ≥90 mmHg or MAP >80 mmHg). Values below 60 mmHg risk end-organ ischaemia.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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