Earlier this week this article was sent out via twitter "Hemostatic resuscitation is neither hemostatic nor resuscitative in trauma hemorrhage" http://bit.ly/1fL9E26
. It has sprouted a conversation about hemostatic resuscitation on twitter that's probably better served here with more ability to chat and discuss.
It's a prospective cohort study showing that during hemostatic resuscitation, patients lactate and coagulopathy worsens until bleeding is definitively controlled. I commented that you need a comparison group to some other treatment to know if hemostatic resuscitation should be abandoned as other approaches may be just as bad. This study can't tell us this as it only looks at one approach. Additionally, I commented that hypoperfusion/anaerobic metabolism isn't where lactate comes from citing this Marik article bit.ly/1jCSpk2
on sepsis. Not the same as trauma (by any stretch) but is the pathophysiology of lactate generation different?