Hillingsø Jens G, Svendsen Lars Bo, Johansson Pär I
Kirurgisk Klinik C 2122, Rigshospitalet, Blegdamsvej 7-9, 2100 København Ø.
Ugeskr Laeger. 2011 May 2;173(18):1271-3.
In multitrauma patients continuous bleeding is one of the major killers. Coagulation defects have been shown to be a primary event and to occur very early in multitrauma patients (acute traumatic coagulopathy). It is enhanced by acidosis, hypothermia and further coagulation disorders in the "bloody vicious cycle". Due to this a new resuscitation practice has been defined; damage control resuscitation, consisting of hypotensive resuscitation (restricted use of crystalloids), haemostatic resuscitation (balanced use of blood components) in combination with surgical haemostatic procedures (damage control surgery).
在多发伤患者中,持续出血是主要致死原因之一。凝血功能障碍已被证明是一个原发性事件,且在多发伤患者中很早就会出现(急性创伤性凝血病)。在“出血恶性循环”中,酸中毒、低温及其他凝血障碍会加重这种情况。因此,一种新的复苏方法被定义出来,即损伤控制复苏,它包括低血压复苏(限制晶体液的使用)、止血复苏(平衡使用血液成分)以及外科止血程序(损伤控制手术)。