Universidad del Valle, Facultad de Salud, Escuela de Medicina, Department of Surgery, Division of Trauma and Acute Care Surgery, Cali, Colombia.
Centro Médico Imbanaco, Cali, Colombia.
Colomb Med (Cali). 2021 May 30;52(2):e4004801. doi: 10.25100/cm.v52i2.4801.
Patients with hemodynamic instability have a sustained systolic blood pressure less or equal to 90 mmHg, a heart rate greater or equal to 120 beats per minute and an acute compromise of the ventilation/oxygenation ratio and/or an altered state of consciousness upon admission. These patients have higher mortality rates due to massive hemorrhage, airway injury and/or impaired ventilation. Damage control resuscitation is a systematic approach that aims to limit physiologic deterioration through strategies that address the physiologic debt of trauma. This article aims to describe the experience earned by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia in the management of the severely injured trauma patient in the emergency department following the basic principles of damage control surgery. Since bleeding is the main cause of death, the management of the severely injured trauma patient in the emergency department requires a multidisciplinary team that performs damage control maneuvers aimed at rapidly controlling bleeding, hemostatic resuscitation, and/or prompt transfer to the operating room, if required.
血流动力学不稳定的患者，其收缩压持续低于或等于 90mmHg，心率持续高于或等于 120 次/分钟，并且在入院时通气/氧合比急性受损和/或意识状态改变。这些患者由于大量出血、气道损伤和/或通气受损，死亡率更高。损伤控制性复苏是一种系统的方法，旨在通过针对创伤生理债务的策略来限制生理恶化。本文旨在描述哥伦比亚卡利创伤和急诊外科小组（CTE）在遵循损伤控制性手术基本原则的情况下，在急诊科对严重创伤患者的管理方面所获得的经验。由于出血是导致死亡的主要原因，因此，在急诊科对严重创伤患者的管理需要一个多学科团队，该团队实施损伤控制性操作，旨在迅速控制出血、止血复苏，以及必要时迅速转移到手术室。
