Damage Control Resuscitation Across the Phases of Major Injury Care
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Purpose of Review
Trauma damage control has undergone a recent paradigm shift, broadening its focus from surgery to resuscitation. This review details central components of damage control resuscitation (DCR) across the phases of major injury care and the evidence behind its adoption.
Permissive hypotension, minimization of crystalloid fluids, and early balanced blood product resuscitation have each been associated with improved outcomes in hemorrhaging patients. These tactics compliment current strategies of achieving hemorrhage control, including damage control surgery.
DCR is now integrated into care from the injury scene, through the resuscitation bay, the operating room, and into the intensive care unit. Its use limits the physiologic derangement experienced by the injured patient and minimizes preventable death from hemorrhage. It has become the accepted standard of modern trauma care and is shaping contemporary trauma systems and education. Future evidence-based advancements in trauma care will be scrutinized against this standard.
KeywordsTrauma Damage control Hemorrhagic shock Coagulopathy Resuscitation
Compliance with Ethical Standards
Conflict of Interest
Dr. Holcomb is the chief medical officer of Prytime Medical Devices (The REBOA Company™), a private company that manufactures a proprietary REBOA balloon catheter. Drs. Cantle and Roberts declare no conflicts of interest relevant to this manuscript.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Human and Animal Rights
All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki Declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines).
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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