title: Bleeding and damage control surgery.
abstract: OBJECTIVE
  Bleeding is still a major cause of death in trauma patients. Damage control surgery is a strategy that aims to control bleeding and avoid secondary contamination of the cavity. This article checks the principles and indications of damage control surgery, bleeding management, and the role of the anesthesiologist in trauma context. The efficient treatment of severe trauma and exsanguinated patients includes a surgical approach to the patient performed as quickly as possible. Volemic resuscitation, hemostatic transfusion, prevention and/or treatment of coagulopathy, hypothermia, and acidosis are strategies that reduce bleeding, as well as permissive hypotension.
  
  
  RESULTS
  Specialized literature shows us that the adoption of all of these principles along with reduced surgical time has led to a broader concept called damage control resuscitation.
  
  
  CONCLUSIONS
  Damage control resuscitation is a treatment strategy in which the recovery of physiological variables is initially prioritized over anatomical variables and can be required in severe trauma patients.
authors.affiliation: aAnesthesia and Intensive Care Department, Hospital das Clínicas bCentral Institute, Hospital das Clínicas - São Paulo University cHospital das Clínicas, São Paulo, Brazil.
authors.forename: Roseny R
authors.initials: RR
authors.lastname: Rodrigues
authors.forename: Maria José C
authors.initials: MJ
authors.lastname: Carmona
authors.forename: Jose Otavio C A
authors.initials: JO
authors.lastname: Junior
mesh_terms: D000138:Acidosis / Q000378:metabolism; D000072080:Anesthesiologists; D001778:Blood Coagulation Disorders / Q000517:prevention & control / Q000628:therapy*; D001779:Blood Coagulation Factors / Q000378:metabolism*; D001803:Blood Transfusion; D006801:Humans; D007023:Hypotension, Controlled; D007035:Hypothermia / Q000378:metabolism; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000628:therapy*; D014947:Wounds and Injuries / Q000150:complications / Q000601:surgery*
chemical_list: D001779:Blood Coagulation Factors