Cantle Paul M, Cotton Bryan A
Division of Acute Care Surgery, Department of Surgery, McGovern Medical School, University Professional Building, Memorial Hermann Hospital, University of Texas, at Houston, 6431 Fannin, MSB 4.286 Houston, TX 77030, USA.
Division of Acute Care Surgery, Department of Surgery, McGovern Medical School, University Professional Building, Memorial Hermann Hospital, University of Texas, at Houston, 6431 Fannin, MSB 4.286 Houston, TX 77030, USA.
Surg Clin North Am. 2017 Oct;97(5):999-1014. doi: 10.1016/j.suc.2017.06.002. Epub 2017 Aug 17.
Over the past decade substantial knowledge has been gained in understanding both the coagulopathy of trauma and the complications associated with aggressive crystalloid-based resuscitation. Balanced resuscitation, which includes permissive hypotension, limiting crystalloid use, and the transfusion of blood products in ratios similar to whole blood, has changed the previous standard of care. Prompt initiation of massive transfusion and the protocolled use of 1:1:1 product ratios have improved the morbidity and mortality of patients with trauma in hemorrhagic shock. Balanced resuscitation minimizes the impact of trauma-induced coagulopathy, limits blood product waste, and reduces the complications that occur with aggressive crystalloid resuscitation.
在过去十年中，我们在理解创伤性凝血病以及与基于晶体液的积极复苏相关的并发症方面取得了大量知识。平衡复苏，包括允许性低血压、限制晶体液使用以及按与全血相似的比例输注血液制品，已经改变了先前的治疗标准。迅速启动大量输血以及按1:1:1的制品比例进行规范使用，改善了失血性休克创伤患者的发病率和死亡率。平衡复苏可将创伤性凝血病的影响降至最低，减少血液制品浪费，并降低积极晶体液复苏所出现的并发症。
