What is it about?
Trauma-associated coagulopathy complicates the resuscitation of patients in hemorrhagic shock. Recent findings indicate that injury to the vascular endothelium destabilizes the complex process of clot formation. Newer strategies of resuscitation targets this problem to restore normal hemostasis to the bleeding trauma patient. We discuss these strategies, how they were developed, and future directions for continued improvement in the care of the trauma victim suffering massive blood loss.
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Why is it important?
Damage control resuscitation has substantially improved survival and contributes to the optimal care of the trauma victim.
Perspectives
Through my 30-year career in medicine I have observed the evolution of our understanding of trauma pathophysiology. This is an excepionally complex subject that involves the interaction of many host defense systems. On a regular basis new information emerges that enhances a deeper understanding of hemorrhagic shock in the trauma patient. Moreover, this information is applicable to management of massive blood loss for other reasons such as gynecological hemorrhagic crises, major bleeding complicating cardiovascular and peripheral vascular procedures, major gastrointestinal bleeding, endstage liver disease, and others.
Timothy Pohlman
Indiana University Health
Read the Original
This page is a summary of: Optimizing transfusion strategies in damage control resuscitation: current insights, Journal of Blood Medicine, August 2018, Dove Medical Press,
DOI: 10.2147/jbm.s165394.
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