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Vol. 66. Issue 7.
Pages 394-404 (August - September 2019)
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Vol. 66. Issue 7.
Pages 394-404 (August - September 2019)
Special article
Damage Control Resuscitation in polytrauma patient
Damage Control Resuscitation en el paciente traumático
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5
M.A. González Posadaa,b,
Corresponding author
miagonza@vhebron.net

Corresponding author.
, A. Biarnés Suñea,b, J.M. Naya Sieiroa, C.I. Salvadores de Arzuagaa, M.J. Colomina Solerc,d
a Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d’Hebron, Barcelona, Spain
b Universidad Autónoma de Barcelona, Barcelona, Spain
c Servicio de Anestesiología y Reanimación, Hospital Universitario de Bellvitge, l’Hospitalet de Llobregat, Barcelona, Spain
d Universidad Barcelona, Barcelona, Spain
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Table 1. Key points in the main studies referenced.
Table 2. Proposed definition of terms used in transfusions and severe bleeding.
Table 3. Examples of different scores activating a mass transfusion protocol.
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Abstract

Haemorrhagic shock is one of the main causes of mortality in severe polytrauma patients. To increase the survival rates, a combined strategy of treatment known as Damage Control has been developed.

The aims of this article are to analyse the actual concept of Damage Control Resuscitation and its three treatment levels, describe the best transfusion strategy, and approach the acute coagulopathy of the traumatic patient as an entity. The potential changes of this therapeutic strategy over the coming years are also described.

Keywords:
Damage Control Resuscitation
Hyperfibrinolisis
Haemorrhagic shock
Tranexamic acid
Traumatic coagulopathy
Polytrauma patient
Resumen

El shock hemorrágico es una de las principales causas de muerte en los pacientes politraumáticos graves. Para aumentar la supervivencia de estos pacientes se ha desarrollado una estrategia combinada de tratamiento conocida como Control de Daños.

Los objetivos de este artículo son analizar el concepto actual de la Reanimación de Control de Daños y sus tres niveles de tratamiento, describir la mejor estrategia transfusional y abordar la coagulopatía aguda del paciente traumático como entidad propia. Se describen también los potenciales cambios que podrían producirse en los próximos años en esta estrategia de tratamiento.

Palabras clave:
Reanimación por control de daños
Hiperfibrinólisis
Shock hemorrágico
Ácido tranexámico
Coagulopatía traumática
Paciente politraumático

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