严重出血的损伤控制复苏

Damage Control Resuscitation for Catastrophic Bleeding.

作者信息

Andreason Chase L, Pohlman Timothy H

机构信息

Department of Oral Surgery and Hospital Dentistry, Indiana University School of Dentistry, 1121 West Michigan Street, Indianapolis, IN 46202, USA.

Trauma Services, Division of General Surgery, Department of Surgery, Methodist Hospital, Indiana University Health, Suite B238, 1701 North Senate Boulevard, Indianapolis, IN 46202, USA.

出版信息

Oral Maxillofac Surg Clin North Am. 2016 Nov;28(4):553-568. doi: 10.1016/j.coms.2016.06.010.

DOI:10.1016/j.coms.2016.06.010

PMID:27745621

Abstract

The timely recognition of shock secondary to hemorrhage from severe facial trauma or as a complication of complex oral and maxillofacial surgery presents formidable challenges. Specific hemostatic disorders are induced by hemorrhage and several extreme homeostatic imbalances may appear during or after resuscitation. Damage control resuscitation has evolved from massive transfusion to a more complex therapeutic paradigm that includes hemodynamic resuscitation, hemostatic resuscitation, and homeostatic resuscitation. Definitive control of bleeding is the principal objective of any comprehensive resuscitation scheme for hemorrhagic shock.

摘要

及时识别因严重面部创伤出血继发的休克或复杂口腔颌面外科手术的并发症，面临着巨大挑战。出血会引发特定的止血障碍，在复苏期间或之后可能会出现几种极端的体内平衡失衡。损伤控制复苏已从大量输血发展为一种更复杂的治疗模式，包括血流动力学复苏、止血复苏和体内平衡复苏。明确控制出血是出血性休克任何综合复苏方案的主要目标。