title: Towards hemostatic resuscitation: the changing understanding of acute traumatic biology, massive bleeding, and damage-control resuscitation.
abstract: During the past decade there has been a profound change in the understanding of postinjury coagulation. Concurrently, new data suggest that a resuscitative strategy to minimize large volumes of crystalloid while recreating whole is associated with reduced morbidity and mortality. This article outlines the history of resuscitation and transfusion practices in trauma, the changing understanding of coagulation and inflammation, and clinical data driving changes in resuscitative conduct. Finally, the current state of the science suggests future basic science and clinical investigation that will drive changes in transfusion and resuscitation in severely injured military personnel and civilian patients.
authors: Department of Surgery, San Francisco General Hospital and the University of California, San Francisco, 1001 Potrero Avenue, Ward 3A, San Francisco, CA 94110, USA. mcohen@sfghsurg.ucsf.edu
authors: Mitchell Jay
authors: MJ
authors: Cohen
mesh_terms: D001778:Blood Coagulation Disorders / Q000209:etiology / Q000266:history / Q000517:prevention & control*; D001803:Blood Transfusion / Q000266:history / Q000379:methods*; D005440:Fluid Therapy / Q000009:adverse effects / Q000266:history / Q000379:methods*; D006489:Hemostatic Techniques / Q000266:history; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008887:Military Medicine / Q000266:history / Q000639:trends; D012151:Resuscitation / Q000009:adverse effects / Q000266:history / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000266:history / Q000503:physiopathology / Q000628:therapy*; D065227:Transfusion Reaction; D014194:Traumatology / Q000266:history / Q000639:trends; D014481:United States; D014947:Wounds and Injuries / Q000150:complications / Q000266:history / Q000503:physiopathology / Q000628:therapy*