What question did this study set out to answer?

To review the rationale and clinical implementation of damage control resuscitation for directly targeting early trauma-induced coagulopathy and the lethal triad in severely injured patients.

February 1, 2007Journal of Trauma and Acute Care Surgery

Damage Control Resuscitation: Directly Addressing the Early Coagulopathy of Trauma

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Authors

JHJohn B. HolcombCleveland State University DJD. G. JenkinsModus Operandi (United States)PRPeter RheeMayo Clinic

Discussion

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Implication

Clinical perspective demonstrates improved physiological stability in severe combat casualties, suggesting early plasma-based damage control resuscitation prevents lethal triad progression.

Key Points

To review the rationale and clinical implementation of damage control resuscitation for directly targeting early trauma-induced coagulopathy and the lethal triad in severely injured patients.
Clinical evaluation of combat trauma resuscitation protocols implemented across military hospitals during Operation Iraqi Freedom and Operation Enduring Freedom.
Implementation of a dual-phase protocol: permissive hypotension targeting approximately 90 mm Hg and plasma-predominant intravascular restoration using a 1:1 or 1:2 plasma-to-red blood cell ratio.
Restriction of crystalloid administration (5 to 8 L in 24 hours), alongside rapid delivery of platelets, cryoprecipitate, recombinant factor VIIa, or fresh whole blood tracked via the Joint Theater Trauma Registry.
Damage control resuscitation markedly reduced intraoperative nonsurgical bleeding, allowing surgical focus to remain primarily on mechanical hemostasis.
Severely injured casualties arrived in intensive care units warm, euvolemic, non-acidotic, and with normal international normalized ratios and minimal edema.
Crystalloid fluid requirements decreased by at least 50% compared with conventional resuscitation practices, facilitating easier mechanical ventilation and earlier extubation.

Cite This Study

Holcomb et al. (2007) studied this question.

synapsesocial.com/papers/6a7e3024b44705ee468562b8 https://doi.org/10.1097/ta.0b013e3180324124

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February 1, 2007Journal of Trauma and Acute Care Surgery

Damage Control Resuscitation: Directly Addressing the Early Coagulopathy of Trauma

View Full Paper

Ask AI

Bookmark

Authors

JHJohn B. HolcombCleveland State University DJD. G. JenkinsModus Operandi (United States)PRPeter RheeMayo Clinic

Discussion

Member takes

Implication

Clinical perspective demonstrates improved physiological stability in severe combat casualties, suggesting early plasma-based damage control resuscitation prevents lethal triad progression.

Key Points

To review the rationale and clinical implementation of damage control resuscitation for directly targeting early trauma-induced coagulopathy and the lethal triad in severely injured patients.
Clinical evaluation of combat trauma resuscitation protocols implemented across military hospitals during Operation Iraqi Freedom and Operation Enduring Freedom.
Implementation of a dual-phase protocol: permissive hypotension targeting approximately 90 mm Hg and plasma-predominant intravascular restoration using a 1:1 or 1:2 plasma-to-red blood cell ratio.
Restriction of crystalloid administration (5 to 8 L in 24 hours), alongside rapid delivery of platelets, cryoprecipitate, recombinant factor VIIa, or fresh whole blood tracked via the Joint Theater Trauma Registry.
Damage control resuscitation markedly reduced intraoperative nonsurgical bleeding, allowing surgical focus to remain primarily on mechanical hemostasis.
Severely injured casualties arrived in intensive care units warm, euvolemic, non-acidotic, and with normal international normalized ratios and minimal edema.
Crystalloid fluid requirements decreased by at least 50% compared with conventional resuscitation practices, facilitating easier mechanical ventilation and earlier extubation.

Cite This Study

Holcomb et al. (2007) studied this question.

synapsesocial.com/papers/6a7e3024b44705ee468562b8 https://doi.org/10.1097/ta.0b013e3180324124

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