Tactical Damage Control Resuscitation

被引:75
作者
Fisher, Andrew D. [1 ]
Miles, Ethan A. [1 ]
Cap, Andrew P. [2 ]
Strandenes, Geir [3 ,4 ]
Kane, Shawn F. [5 ]
机构
[1] 75th Ranger Regiment, Ft Benning, GA 31905 USA
[2] US Army, Inst Surg Res, Ft Sam Houston, TX 78234 USA
[3] Norwegian Naval Special Operat Commando, Bergen, Norway
[4] Haukeland Hosp, Dept Immunol & Transfus Med, N-5021 Bergen, Norway
[5] US Army Special Operat Command, Ft Bragg, NC 28310 USA
关键词
FRESH WHOLE-BLOOD; COMBAT CASUALTY CARE; FLUID RESUSCITATION; TRAUMA PATIENTS; TRANSFUSION; PLASMA; PLATELETS; CELLS; RATIO; MORTALITY;
D O I
10.7205/MILMED-D-14-00721
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Recently the Committee on Tactical Combat Casualty Care changed the guidelines on fluid use in hemorrhagic shock. The current strategy for treating hemorrhagic shock is based on early use of components: Packed Red Blood Cells (PRBCs), Fresh Frozen Plasma (FFP) and platelets in a 1:1:1 ratio. We suggest that lack of components to mimic whole blood functionality favors the use of Fresh Whole Blood in managing hemorrhagic shock on the battlefield. We present a safe and practical approach for its use at the point of injury in the combat environment called Tactical Damage Control Resuscitation. We describe pre-deployment preparation, assessment of hemorrhagic shock, and collection and transfusion of fresh whole blood at the point of injury. By approaching shock with goal-directed therapy, it is possible to extend the period of survivability in combat casualties.
引用
收藏
页码:869 / 875
页数:7
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