Rodrigues Roseny R, Carmona Maria José C, Junior Jose Otavio C A
aAnesthesia and Intensive Care Department, Hospital das Clínicas bCentral Institute, Hospital das Clínicas - São Paulo University cHospital das Clínicas, São Paulo, Brazil.
Curr Opin Anaesthesiol. 2016 Apr;29(2):229-33. doi: 10.1097/ACO.0000000000000288.
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.
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.
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.
出血仍是创伤患者的主要死亡原因。损伤控制手术是一种旨在控制出血并避免体腔继发污染的策略。本文探讨损伤控制手术的原则和适应证、出血管理以及麻醉医生在创伤情况下的作用。对严重创伤和失血性患者的有效治疗包括尽快对患者采取手术方法。容量复苏、止血输血、预防和/或治疗凝血病、体温过低和酸中毒以及允许性低血压都是减少出血的策略。
专业文献表明，采用所有这些原则并缩短手术时间已形成一个更广泛的概念，即损伤控制复苏。
损伤控制复苏是一种治疗策略，在这种策略中，生理变量的恢复最初优先于解剖变量，严重创伤患者可能需要采用该策略。
