Kaafarani H M A, Velmahos G C
Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA.
Scand J Surg. 2014 Jun;103(2):81-88. doi: 10.1177/1457496914524388. Epub 2014 Apr 28.
Most preventable trauma deaths are due to uncontrolled hemorrhage.
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.
Damage control resuscitation strategies include body rewarming, restrictive fluid administration, permissive hypotension, balanced blood product administration, and the implementation of massive transfusion protocols.
Resuscitating and correcting the coagulopathy of the exsanguinating trauma patient is essential to improve chances of survival.
大多数可预防的创伤死亡是由于出血无法控制。
在本文中，我们简要描述创伤中经典死亡三联征（即酸中毒、低温和凝血功能障碍）的病理生理学，然后提出损伤控制复苏策略，以预防和/或减轻出血患者中每种情况的影响。
损伤控制复苏策略包括身体复温、限制性液体输注、允许性低血压、平衡血液制品输注以及实施大量输血方案。
对正在大量出血的创伤患者进行复苏并纠正其凝血功能障碍对于提高生存几率至关重要。
