What is permissive hypotension, and what SBP target is commonly used during uncontrolled hemorrhage?

• A. Deliberate lowering of blood pressure to limit ongoing bleeding; SBP around 80-90 mmHg (MAP ~60) until hemorrhage control
• B. Maintaining SBP at 120-130
• C. Raising SBP above 140
• D. No blood pressure targets during hemorrhage

Answer: (A)

Permissive hypotension is a resuscitation approach used during uncontrolled hemorrhage that intentionally keeps blood pressure lower than normal to limit ongoing bleeding and avoid dislodging forming clots, until definitive hemorrhage control is achieved. The commonly used target is an SBP around 80-90 mmHg, with a MAP near 60 mmHg, just high enough to maintain perfusion to vital organs like the heart and brain without driving more bleeding. Maintaining normal blood pressure (around 120-130 SBP) or pushing SBP above 140 can worsen bleeding by increasing pressure at the injury site, and there is still a guided target during resuscitation rather than no target at all. The goal is to balance adequate perfusion with minimizing further hemorrhage.