Damage Control Resuscitation In Trauma.
BACKGROUND
Most preventable trauma deaths are due to uncontrolled hemorrhage.


METHODS
In this article, we briefly describe the pathophysiology of the classical triad of death in trauma, namely, acidosis, hypothermia, and coagulopathy, and then suggest damage control resuscitation strategies to prevent and/or mitigate the effects of each in the bleeding patient.


RESULTS
Damage control resuscitation strategies include body rewarming, restrictive fluid administration, permissive hypotension, balanced blood product administration, and the implementation of massive transfusion protocols.


CONCLUSIONS
Resuscitating and correcting the coagulopathy of the exsanguinating trauma patient is essential to improve chances of survival.
Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA hkaafarani@partners.org.
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Kaafarani
Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
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Velmahos
Resuscitation; acidosis; blood component transfusion; consumption coagulopathy; hemorrhage; wounds and injury