Purpose of Review : This review examines our current understanding of the complex hemodynamic changes following major trauma and how existing advanced monitoring techniques can be leveraged to address these challenges.

Recent Findings : The management of major trauma has improved recently with more patients surviving injuries previously considered unsurvivable. The initial phase of shock, most commonly due to hypovolemia, can evolve into a complex, multifactorial state involving cardiogenic shock and vasoplegia along a predictable timeline. Without advanced monitoring methods, treatment can be difficult to tailor and can even lead to harm.

Summary : In major trauma patients, correctly identifying the causes of shock is essential to permit optimal resuscitation. In many patients, non-invasive and minimally invasive monitoring will provide sufficient hemodynamic information. Advanced monitoring techniques will benefit the significant minority of patients who develop more complex circulatory collapse, especially those requiring advanced interventions such as mechanical circulatory support.