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Damage Control Resuscitation: More Than Just Transfusion Strategies

  • Anesthesia for Trauma (JW Simmons, Section Editor)
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Abstract

Trauma hemorrhage continues to carry a high mortality worldwide. The contemporary damage control resuscitation (DCR) paradigm supports actively bleeding trauma patients until hemorrhage control is achieved. The principles of DCR center on early hemorrhage control and limiting ongoing blood loss by adopting strategies limiting fluid administration, reducing blood pressure targets, and maintaining hemostasis through balanced transfusion strategies. Application of DCR strategies has dramatically reduced mortality from trauma hemorrhage and also seems to reduce the incidence and severity of complications such as organ failure and infection. While much of the discussion around DCR focuses on control of coagulopathy and the delivery of a balanced transfusion, the other principles are at least as important. Avoiding clear fluids solutions, especially at the most critical timepoints, require experience and a coordinated, practiced, multidisciplinary approach. The anesthesiologist therefore has a central role to play in the successful delivery of DCR, and perioperative management of fluid administration and the patient’s cardiovascular status can make all the difference between a good and bad outcome. In this article, we discuss the principles of DCR with a focus on areas of trauma anesthesiology management.

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Author information

Authors and Affiliations

  1. Anesthesia Department, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Catherine Heim

  2. Department of Anesthesia and Perioperative Care, San Francisco General Hospital, UCSF, 1001 Potrero Ave, Room 3C-38, San Francisco, CA, 94110, USA

    Marc P. Steurer

  3. Centre for Trauma Sciences, Queen Mary University of London, 2 Newark St, London, E1 2AT, UK

    Karim Brohi

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  1. Catherine Heim
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  2. Marc P. Steurer
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  3. Karim Brohi
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Correspondence to Catherine Heim.

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This article is part of the Topical Collection on Anesthesia for Trauma.

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Heim, C., Steurer, M.P. & Brohi, K. Damage Control Resuscitation: More Than Just Transfusion Strategies. Curr Anesthesiol Rep 6, 72–78 (2016). https://doi.org/10.1007/s40140-016-0145-x

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  • DOI: https://doi.org/10.1007/s40140-016-0145-x

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