title: Hemostatic resuscitation in traumatic hemorrhagic shock: case report.
abstract: OBJECTIVE
  The aim of this paper is to report a case in which the damage control resuscitation (DCR) approach was successfully used to promote hemostatic resuscitation in a polytraumatized patient with severe hemorrhagic shock.
  
  
  METHODS
  Female patient, 32 years of age, with severe hemorrhagic shock due to polytrauma with hip fracture, who developed acidosis, coagulopathy, and hypothermia. During fluid resuscitation, the patient received blood products transfusion of fresh frozen plasma/packed red blood cells/platelet concentrate at a ratio of 1:1:1 and evolved intraoperatively with improvement in perfusion parameters without requiring vasoactive drugs. At the end of the operation, the patient was taken to the intensive care unit and discharged on the seventh postoperative day
  
  
  CONCLUSIONS
  : The ideal management of traumatic hemorrhagic shock is not yet established, but the rapid control of bleeding and perfusion recovery and well-defined therapeutic protocols are fundamental to prevent progression of coagulopathy and refractory shock.
authors.affiliation: Anesthesiologist at Department of Anesthesia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP). Electronic address: osvbarbosa@yahoo.com.br.
authors.forename: José Osvaldo
authors.initials: JO
authors.lastname: Barbosa Neto
authors.affiliation: Resident Physician at Department of Anesthesia, Hospital das Clínicas, FMUSP; Specialization in Anesthesiology, Centro de Ensino e Treinamento, Sociedade Brasileira de Anestesiologia (SBA).
authors.forename: Marcos Fernando Breda
authors.initials: MF
authors.lastname: de Moraes
authors.affiliation: TSA; Anestheiologist, at Department of Anesthesia, Hospital das Clínicas, FMUSP.
authors.forename: Ricardo Souza
authors.initials: RS
authors.lastname: Nani
authors.affiliation: TSA; Anestheiologist, at Department of Anesthesia, Hospital das Clínicas, FMUSP; PHD in Medical Sciences, FMUSP.
authors.forename: Joel Avancini
authors.initials: JA
authors.lastname: Rocha Filho
authors.affiliation: TSA; Associate Professor, FMUSP.
authors.forename: Maria José Carvalho
authors.initials: MJ
authors.lastname: Carmona
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D005260:Female; D006487:Hemostasis; D006801:Humans; D009104:Multiple Trauma / Q000150:complications / Q000628:therapy; D012151:Resuscitation / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000628:therapy*
keywords: Blood Component; Hemorrhagic.; Multiple trauma; Shock