Damage Control Resuscitation In Trauma

H M A Kaafarani; G C Velmahos

doi:10.1177/1457496914524388

Damage Control Resuscitation In Trauma

Scand J Surg. 2014 Jun;103(2):81-88. doi: 10.1177/1457496914524388. Epub 2014 Apr 28.

Authors

H M A Kaafarani¹, G C Velmahos²

Affiliations

¹ Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA hkaafarani@partners.org.
² Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.

PMID: 24777616
DOI: 10.1177/1457496914524388

Abstract

Introduction: Most preventable trauma deaths are due to uncontrolled hemorrhage.

Methods: In this article, we briefly describe the pathophysiology of the classical triad of death in trauma, namely, acidosis, hypothermia, and coagulopathy, and then suggest damage control resuscitation strategies to prevent and/or mitigate the effects of each in the bleeding patient.

Results: Damage control resuscitation strategies include body rewarming, restrictive fluid administration, permissive hypotension, balanced blood product administration, and the implementation of massive transfusion protocols.

Conclusion: Resuscitating and correcting the coagulopathy of the exsanguinating trauma patient is essential to improve chances of survival.

Keywords: Resuscitation; acidosis; blood component transfusion; consumption coagulopathy; hemorrhage; wounds and injury.

Publication types

Review