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n 1990, about 5 million people died worldwide as a result of injury, and it seems likely that the global epidemic of deadly trauma is only beginning. By 2020, deaths from injury are expected to increase to 8 million worldwide (2), and 30% of these fatalities will be attributable to uncontrolled hemorrhagic shock (3). Resuscitation of patients in uncontrolled hemorrhagic shock remains one of the most challenging aspects of emergency care, and trauma patients with complete cardiovascular collapse have an extremely poor chance of survival. For example, in a 1993 study of 138 trauma patients requiring cardiopulmonary resuscita- tion at the accident scene or during transport, none of the initially successfully resuscitated patients survived to hospital discharge (4). Accordingly, prevention of cardiac arrest has been considered to be the primary goal of trauma care (5). Unfortunately, trauma-related cardiac arrest is only the tip of the iceberg. Because hemorrhage-induced hypotension in trauma patients is predictive of frequent mortality and morbidity (6), fighting prolonged hypotension may be equally important. For hemodynamic stabilization of critically injured patients with uncontrolled hemorrhagic shock current trauma guidelines recommend infusion of crystalloid or colloid solutions in addition to catecholamine va- sopressors. In a large clinical study of penetrating

Vasopressin During Uncontrolled Hemorrhagic Shock: Less Bleeding Below the Diaphragm, More Perfusion Above