ICU · Trauma

Damage-Control Resuscitation & Surgery — The Lethal Triad & Planned Re-operation

Also known as Damage-control resuscitation · DCR · Damage-control surgery · DCS · Lethal triad · Permissive hypotension · Open abdomen · Planned re-operation · Abbreviated laparotomy

Damage-control resuscitation (DCR) and damage-control surgery (DCS) — the integrated approach to the exsanguinating trauma patient. DCR: the permissive hypotension (SBP 80 to 90 until the bleeding controlled), the MTP 1:1:1 (RBC:plasma:platelets), the TXA within 3 hours, the minimise the crystalloid (worsens dilutional coagulopathy and the acidosis), the warm. DCS: the abbreviated the laparotomy (the packing to control the bleeding, the temporary the closure, NOT definitive repair), the correct the lethal triad (the acidosis, the hypothermia, the coagulopathy), and the planned the re-operation at the 24 to 48 hours (the definitive the repair, the anastomosis, the closure). The open the abdomen (the manage the intra-abdominal the hypertension, the fistula, the fluid the losses).