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Damage Control Resuscitation.

James N Bogert1, John A Harvin1, Bryan A Cotton2

  • 1Department of Surgery, University of Texas Medical School at Houston, Houston, TX, USA.

Journal of Intensive Care Medicine
|November 12, 2014
PubMed
Summary
This summary is machine-generated.

Damage control resuscitation (DCR) improves outcomes for hemorrhaging patients by managing coagulopathy, acidosis, and hypothermia. This approach combines hemostatic resuscitation and damage control surgery, enhanced by pharmacologic and laboratory adjuncts.

Keywords:
damage controlhemorrhagemassive transfusionresuscitation

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Area of Science:

  • Trauma and Emergency Medicine
  • Critical Care Medicine
  • Surgical Resuscitation

Background:

  • Hemorrhaging patients present complex physiologic derangements including coagulopathy, acidosis, and hypothermia.
  • Traditional resuscitation strategies have evolved significantly over the past decade.
  • The concept of damage control resuscitation (DCR) has emerged as a paradigm shift.

Purpose of the Study:

  • To review the core strategies of damage control resuscitation (DCR).
  • To discuss the adjuncts that augment DCR for hemorrhaging patients.
  • To elucidate the role of DCR in modern patient care.

Main Methods:

  • Review of current literature on damage control resuscitation and hemostatic resuscitation.
  • Discussion of key components: permissive hypotension, transfusion ratios, and limited crystalloid use.
  • Integration of damage control surgery principles with resuscitation strategies.

Main Results:

  • DCR integrates hemostatic resuscitation and damage control surgery for improved patient outcomes.
  • Key strategies include permissive hypotension, optimized blood product ratios, and judicious crystalloid use.
  • Adjuncts like thrombelastography, tranexamic acid, and activated factor VII enhance DCR effectiveness.

Conclusions:

  • Damage control resuscitation (DCR) represents a comprehensive approach to managing hemorrhaging patients.
  • The combination of DCR strategies and adjuncts has demonstrably improved outcomes.
  • Continued research and application of DCR principles are vital for critical care.