Journal
SHOCK
Volume 56, Issue 1, Pages 42-51Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/SHK.0000000000001676
Keywords
Balanced resuscitation; coagulopathy; complications; crystalloid; damage control resuscitation; hemorrhagic shock; massive transfusion; trauma
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Trauma remains a leading cause of death, with hemorrhage being the leading preventable cause. In the past 20 years, resuscitation strategies for trauma have significantly changed, moving from large volume crystalloid resuscitation to a 1:1:1 ratio of packed red blood cells, fresh plasma, and platelets.
Trauma remains a leading cause of death, and hemorrhage is the leading cause of preventable trauma deaths. Resuscitation strategies in trauma have changed dramatically over the last 20 years. In the pre damage control resuscitation (DCR) era, we used large volume crystalloid resuscitation and packed red blood cells as the primary resuscitative fluids. Now, a 1:1:1 ratio of packed red blood cells, fresh plasma, and platelets with minimal crystalloids is the preferred resuscitative strategy (DCR era). As we have changed how we resuscitate patients, the detrimental effects associated with large volume resuscitation have also changed. In this article, we review the effects of large volume blood product resuscitation, and where possible present a contrast between the pre-DCR era and the DCR era resuscitation strategies.
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