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Review
. 2014 Feb;57(1):55-60.
doi: 10.1503/cjs.020312.

Damage control resuscitation: history, theory and technique

Chad G Ball  1
Affiliations
Review

Damage control resuscitation: history, theory and technique

Chad G Ball. Can J Surg. 2014 Feb.

Abstract
in English, French

Damage control resuscitation (DCR) represents the natural evolution of the initial concept of damage control surgery. It currently includes early blood product transfusion, immediate arrest and/or temporization of ongoing hemorrhage (i.e., temporary intravascular shunts and/or balloon tamponade) as well as restoration of blood volume and physiologic/hematologic stability. As a result, DCR addresses the early coagulopathy of trauma, avoids massive crystalloid resuscitation and leaves the peritoneal cavity open when a patient approaches physiologic exhaustion without improvement. This concept also applies to severe injuries within anatomical transition zones as well as extremities. This review will discuss each of these concepts in detail.

La réanimation salvatrice et conservatrice découle naturellement du concept initial de chirurgie salvatrice et conservatrice. Ce concept repose actuellement sur l’administration rapide de transfusions sanguines, l’arrêt et(ou) la temporisation immédiats de l’hémorragie active (c.-à-d., dérivations intravasculaires temporaires et(ou) tamponnade par ballonnet), de même que le rétablissement du volume sanguin et la stabilisation de l’état physiologique et hématologique. Ainsi, la réanimation salvatrice et conservatrice corrige rapidement la coagulopathie post-traumatique, permet d’éviter les mesures de réanimation par cristalloïdes et laisse la cavité péritonéale ouverte lorsqu’un patient atteint l’épuisement physiologique sans amélioration. Le concept s’applique aussi au blessures graves affectant des zones anatomiques de transition ou les membres. Cette analyse abordera chacun des éléments du concept plus en détail.

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