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A key issue is that vasoconstriction is insufficient to arrest the bleeding when damage is made to a major blood vessel. \u2018Uncontrolled hemorrhage\u2019 is rather stopped by a blood clot formed at the outside surface of the vessel, and the immature clot is sensitive to mechanical and chemical interactions. The mortality increases if rebleeding occurs. In the aortic tear model in swine, hemorrhage volume and the mortality increase from effective restoration of the arterial pressure. The mortality vs. amount of fluid curve is <jats:styled-content style=\"fixed-case\">U<\/jats:styled-content>\u2010shaped with higher mortality at either end. Without any fluid at all, irreversible shock causes death provided the hemorrhage is sufficiently large. Crystalloid fluid administered in a 3\u2009:\u20091 proportion to the amount of lost blood initiates serious rebleeding. Hypertonic saline 7.5% in 6% dextran 70 (<jats:styled-content style=\"fixed-case\">HSD<\/jats:styled-content>) also provokes rebleeding resulting in higher mortality in the recommended dosage of 4\u2009ml\/kg. Uncontrolled hemorrhage models in rats, except for the \u2018cut\u2010tail\u2019 model, confirm the results from swine. To avoid rebleeding, fluid programs should not aim to fully restore the arterial pressure, blood flow rates, or blood volume. For a hemorrhage of 1000\u2009ml, computer simulations show that deliberate hypovolemia (\u2212300\u2009ml) would be achieved by infusing 600\u2013750\u2009ml crystalloid fluid over 20\u201330\u2009min or 100\u2009ml of <jats:styled-content style=\"fixed-case\">HSD<\/jats:styled-content> over 10\u201320\u2009min in an adult male.<\/jats:p>","DOI":"10.1111\/j.1399-6576.2012.02763.x","type":"journal-article","created":{"date-parts":[[2012,9,4]],"date-time":"2012-09-04T15:29:42Z","timestamp":1346772582000},"page":"16-28","source":"Crossref","is-referenced-by-count":39,"title":["Fluid therapy in uncontrolled hemorrhage \u2013 what experimental models have taught us"],"prefix":"10.1111","volume":"57","author":[{"given":"R. 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