Permissive Hypotension in Trauma Resuscitation: A Comprehensive Academic Review

Permissive hypotension, also termed hypotensive resuscitation, represents a deliberate clinical strategy wherein mean arterial pressure (MAP) is intentionally maintained below normal physiological thresholds. This approach is primarily employed in the management of acute hemorrhagic volume depletion consequent to severe trauma. Hemorrhagic shock remains among the leading causes of mortality in trauma populations. Permissive hypotension functions exclusively as a temporizing measure pending definitive hemorrhage control or surgical intervention. Upon availability of blood products and enhanced hemorrhage control measures, hemodynamic parameters should be restored to normal ranges. This comprehensive review examines the physiological rationale, clinical indications, contraindications, technical considerations, and interprofessional management aspects of hypotensive resuscitation, synthesizing current evidence to inform contemporary trauma practice.