The Evolving Science of Trauma Resuscitation

被引：48

作者：

Harris, Tim ^{[1
]}

Davenport, Ross ^{[2
]}

Mak, Matthew ^{[3
]}

Brohi, Karim ^{[4
,5
]}

机构：

[1] Queen Mary Univ London, Barts Hlth NHS Trust, Emergency Med, London, England

[2] Queen Mary Univ London, Blizard Inst, Trauma Sci, London, England

[3] Barts Hlth NHS Trust, Emergency Med, London, England

[4] Queen Mary Univ London, Blizard Inst, Trauma & Neurosci, London E1 2AT, England

[5] Barts Hlth NHS Trust, Londons Air Ambulance, London, England

来源：

EMERGENCY MEDICINE CLINICS OF NORTH AMERICA | 2018年 / 36卷 / 01期

关键词：

Trauma resuscitation; Hypovolemia; Trauma-induced coagulopathy; Viscoelastie hemostatic assays; Endothelial damage; Hemostasis; UNCONTROLLED HEMORRHAGIC-SHOCK; RECEIVING MASSIVE TRANSFUSIONS; PREHOSPITAL INTRAVENOUS FLUID; DAMAGE CONTROL RESUSCITATION; SEVERELY INJURED PATIENTS; SYSTOLIC BLOOD-PRESSURE; MAJOR TRAUMA; EMERGENCY-DEPARTMENT; ARGININE-VASOPRESSIN; TRANEXAMIC ACID;

D O I：

10.1016/j.emc.2017.08.009

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

This article summarizes the evolution of trauma resuscitation from a one size-fits-all approach to one tailored to patient physiology. The most dramatic change is in the management of actively bleeding patients, with a balanced blood product-based resuscitation approach (avoiding crystalloids) and surgery focused on hemorrhage control, not definitive care. When hemostasis has been achieved, definitive resuscitation to restore organ perfusion is initiated. This approach is associated with decreased mortality, reduced duration of stay, improved coagulation profile, and reduced crystalloid/vasopressor use. This article focuses on the tools and methods used for trauma resuscitation in the acute phase of trauma care.

引用

页码：85 / +

页数：23

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