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Damage Control Resuscitation
Damage control resuscitation is a resuscitation modality that integrates permissive hypotension, hemostatic resuscitation, and damage control surgery, initially addressing all three components of the “lethal triad”: coagulopathy, acidosis, and hypothermia. Trauma patients predicted to require massiv...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120797/ http://dx.doi.org/10.1007/978-88-470-5403-5_3 |
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author | Duchesne, Juan Carlos Pereira, Bruno Monteiro Fraga, Gustavo Pereira |
author_facet | Duchesne, Juan Carlos Pereira, Bruno Monteiro Fraga, Gustavo Pereira |
author_sort | Duchesne, Juan Carlos |
collection | PubMed |
description | Damage control resuscitation is a resuscitation modality that integrates permissive hypotension, hemostatic resuscitation, and damage control surgery, initially addressing all three components of the “lethal triad”: coagulopathy, acidosis, and hypothermia. Trauma patients predicted to require massive transfusion, administration of fresh frozen plasma, packed red blood cells, and platelets in a 1:1:1 ratio (of individual units) are associated with improved survival and less need for innumerous transfusions. In addition, the evidence so far indicates that the incorporation of these principles into a MTP will also contribute to less transfused units by minimizing variability of transfusion practices. Importantly, fewer units transfused will contribute to fewer complications associated with transfusions. These conclusions will need to be verified, especially with regard to the effect of MTPs incorporating higher ratios of FFP:PRBC:platelets effect on varying mechanism of injury, the timing of transfusions, and the number of units actually transfused. Also recombinant factor VIIa, cryoprecipitate, and tranexamic acid can be considered adjunctive treatments for coagulopathy. Lastly, damage control surgery is a surgical strategy aimed at restoring normal physiology rather than anatomical integrity; however, this component of damage control resuscitation should not be applied in isolation. |
format | Online Article Text |
id | pubmed-7120797 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
record_format | MEDLINE/PubMed |
spelling | pubmed-71207972020-04-06 Damage Control Resuscitation Duchesne, Juan Carlos Pereira, Bruno Monteiro Fraga, Gustavo Pereira Trauma Surgery Article Damage control resuscitation is a resuscitation modality that integrates permissive hypotension, hemostatic resuscitation, and damage control surgery, initially addressing all three components of the “lethal triad”: coagulopathy, acidosis, and hypothermia. Trauma patients predicted to require massive transfusion, administration of fresh frozen plasma, packed red blood cells, and platelets in a 1:1:1 ratio (of individual units) are associated with improved survival and less need for innumerous transfusions. In addition, the evidence so far indicates that the incorporation of these principles into a MTP will also contribute to less transfused units by minimizing variability of transfusion practices. Importantly, fewer units transfused will contribute to fewer complications associated with transfusions. These conclusions will need to be verified, especially with regard to the effect of MTPs incorporating higher ratios of FFP:PRBC:platelets effect on varying mechanism of injury, the timing of transfusions, and the number of units actually transfused. Also recombinant factor VIIa, cryoprecipitate, and tranexamic acid can be considered adjunctive treatments for coagulopathy. Lastly, damage control surgery is a surgical strategy aimed at restoring normal physiology rather than anatomical integrity; however, this component of damage control resuscitation should not be applied in isolation. 2013-08-19 /pmc/articles/PMC7120797/ http://dx.doi.org/10.1007/978-88-470-5403-5_3 Text en © Springer-Verlag Italia 2014 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Article Duchesne, Juan Carlos Pereira, Bruno Monteiro Fraga, Gustavo Pereira Damage Control Resuscitation |
title | Damage Control Resuscitation |
title_full | Damage Control Resuscitation |
title_fullStr | Damage Control Resuscitation |
title_full_unstemmed | Damage Control Resuscitation |
title_short | Damage Control Resuscitation |
title_sort | damage control resuscitation |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7120797/ http://dx.doi.org/10.1007/978-88-470-5403-5_3 |
work_keys_str_mv | AT duchesnejuancarlos damagecontrolresuscitation AT pereirabrunomonteiro damagecontrolresuscitation AT fragagustavopereira damagecontrolresuscitation |