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失血性休克与大量输血的并发症——损伤控制复苏时代前后的比较

Complications of Hemorrhagic Shock and Massive Transfusion-a Comparison Before and After the Damage Control Resuscitation Era.

作者信息

Black Jonathan A, Pierce Virginia S, Juneja Kavina, Holcomb John B

机构信息

Division of Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.

Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.

出版信息

Shock. 2021 Jul 1;56(1):42-51. doi: 10.1097/SHK.0000000000001676.

Abstract

Trauma remains a leading cause of death, and hemorrhage is the leading cause of preventable trauma deaths. Resuscitation strategies in trauma have changed dramatically over the last 20 years. In the pre damage control resuscitation (DCR) era, we used large volume crystalloid resuscitation and packed red blood cells as the primary resuscitative fluids. Now, a 1:1:1 ratio of packed red blood cells, fresh plasma, and platelets with minimal crystalloids is the preferred resuscitative strategy (DCR era). As we have changed how we resuscitate patients, the detrimental effects associated with large volume resuscitation have also changed. In this article, we review the effects of large volume blood product resuscitation, and where possible present a contrast between the pre-DCR era and the DCR era resuscitation strategies.

摘要

创伤仍然是主要的死亡原因,而出血是可预防的创伤死亡的主要原因。在过去20年里,创伤复苏策略发生了巨大变化。在损伤控制复苏(DCR)时代之前,我们使用大量晶体液复苏和浓缩红细胞作为主要的复苏液体。现在,浓缩红细胞、新鲜血浆和血小板按1:1:1的比例搭配并尽量少用晶体液是首选的复苏策略(DCR时代)。随着我们改变了对患者的复苏方式,与大量复苏相关的有害影响也发生了变化。在本文中,我们回顾了大量血液制品复苏的影响,并尽可能对比DCR时代之前和DCR时代的复苏策略。

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