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Revisión bibliográfica: damage control resuscitation

Damage control resuscitation es una nueva estrategia de reanimación establecida para el paciente politraumatizado grave, que ha sido objeto de muchas revisiones desde su aparición.

Surge como opción inicial de tratamiento para revertir la coagulopatía, hipotermia y acidosis metabólica, que aparecen fisiológicamente tras un traumatismo grave. Siendo, el sangrado no controlado  la causa principal de muerte más frecuente del trauma.

Para prevenir estas muertes es fundamental corregir la sintomatología de la triada clásica de mortalidad, para ello damage control resuscitation desarrolla la hipotensión permisiva que consiste mantener la presión arterial sistólica en torno a 90 mm Hg, corrige la acidosis y la hipotermia a través de la  administración rápida y temprana de fluidos y  hemoderivados.

No se ha demostrado que haya un fluido con efecto superior a otro en el abordaje del trauma. Aunque parece adecuado administrar de forma precoz plasma, concentrado de hematíes y plaquetas en una proporción de 1:1:1.

Los pacientes estables deben manejarse con una estrategia transfusional restrictiva.

Anexos 

Anexos – Revisión bibliográfica. Damage control resuscitation

Anexos – Revisión bibliográfica. Damage control resuscitation

BIBLIOGRAFÍA.

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