Tourtier J-P, Palmier B, Tazarourte K, Raux M, Meaudre E, Ausset S, Sailliol A, Vivien B, Domanski L, Carli P
Emergency Department, Fire Brigade of Paris, 1, place Jules-Renard, 75017 Paris, France.
Ann Fr Anesth Reanim. 2013 Jul-Aug;32(7-8):520-6. doi: 10.1016/j.annfar.2013.07.012. Epub 2013 Jul 31.
The purpose of this review is to present the progressive extension of the concept of damage control resuscitation, focusing on the prehospital phase.
Review of the literature in Medline database over the past 10 years.
Medline database looking for articles published in English or in French between April 2002 and March 2013. Keywords used were: damage control resuscitation, trauma damage control, prehospital trauma, damage control surgery. Original articles were firstly selected. Editorials and reviews were secondly studied.
The importance of early management of life-threatening injuries and rapid transport to trauma centers has been widely promulgated. Technical progress appears for external methods of hemostasis, with the development of handy tourniquets and hemostatic dressings, making the crucial control of external bleeding more simple, rapid and effective. Hypothermia is independently associated with increased risk of mortality, and appeared accessible to improvement of prehospital care. The impact of excessive fluid resuscitation appears negative. The interest of hypertonic saline is denied. The place of vasopressor such as norepinephrine in the early resuscitation is still under debate. The early use of tranexamic acid is promoted. Specific transfusion strategies are developed in the prehospital setting.
It is critical that both civilian and military practitioners involved in trauma continue to share experiences and constructive feedback. And it is mandatory now to perform well-designed prospective clinical trials in order to advance the topic.
本综述的目的是阐述损伤控制复苏概念的逐步扩展，重点关注院前阶段。
对过去10年Medline数据库中文献的综述。
Medline数据库，查找2002年4月至2013年3月期间以英文或法文发表的文章。使用的关键词为：损伤控制复苏、创伤损伤控制、院前创伤、损伤控制手术。首先选择原创文章，其次研究社论和综述。
危及生命损伤的早期处理以及快速转运至创伤中心的重要性已得到广泛宣传。随着便捷止血带和止血敷料的发展，外部止血方法取得技术进步，使对外出血的关键控制更加简单、快速和有效。体温过低与死亡率增加独立相关，且似乎可通过改善院前护理得到改善。过量液体复苏的影响似乎是负面的。高渗盐水的作用未得到证实。去甲肾上腺素等血管加压药在早期复苏中的地位仍存在争议。促进早期使用氨甲环酸。在院前环境中制定了特定的输血策略。
参与创伤救治的 civilian 和 military 从业者继续分享经验和建设性反馈至关重要。现在必须进行精心设计的前瞻性临床试验，以推进该主题的研究。 （注：“civilian”和“military”在医学语境中可能有特定含义，这里按字面翻译，具体含义需结合上下文确定）
