Towards Hemostatic Resuscitation The Changing Understanding of Acute Traumatic Biology, Massive Bleeding, and Damage-Control Resuscitation

Department of Surgery, San Francisco General Hospital and the University of California, San Francisco, 1001 Potrero Avenue, Ward 3A, San Francisco, CA 94110, USA.
Surgical Clinics of North America (Impact Factor: 1.93). 08/2012; 92(4):877-91, viii. DOI: 10.1016/j.suc.2012.06.001
Source: PubMed

ABSTRACT During the past decade there has been a profound change in the understanding of postinjury coagulation. Concurrently, new data suggest that a resuscitative strategy to minimize large volumes of crystalloid while recreating whole is associated with reduced morbidity and mortality. This article outlines the history of resuscitation and transfusion practices in trauma, the changing understanding of coagulation and inflammation, and clinical data driving changes in resuscitative conduct. Finally, the current state of the science suggests future basic science and clinical investigation that will drive changes in transfusion and resuscitation in severely injured military personnel and civilian patients.

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