Damage control resuscitation: REBOA as the new fourth pillar
Abstract
Damage Control Resuscitation (DCR) seeks to combat metabolic decompensation of the severely injured trauma patient by battling on three major fronts: Permissive Hypotension, Hemostatic Resuscitation, and Damage Control Surgery (DCS). The aim of this article is to perform a review of the history of DCR/DCS and to propose a new paradigm that has emerged from the recent advancements in endovascular technology: The Resuscitative Balloon Occlusion of the Aorta (REBOA). Thanks to the advances in technology, a bridge has been created between Pre-hospital Management and the Control of Bleeding described in Stage I of DCS which is the inclusion and placement of a REBOA. We have been able to show that REBOA is not only a tool that aids in the control of hemorrhage, it is also a vital tool in the hemodynamic resuscitation of a severely injured blunt and/or penetrating trauma patient. That is why we propose a new paradigm “The Fourth Pillar”: Permissive Hypotension, Hemostatic Resuscitation, Damage Control Surgery and REBOA.
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Keywords
- Damage Control Surgery
- Damage Control Resuscitation
- REBOA
- Trauma Centers
- Thrombelastography
- Advanced Trauma Life Support Care
- Tourniquets
- Triage
- Fibrinogen
- Hypothermia
- Intra-Abdominal Hypertension
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Copyright (c) 2020 carlos ordoñez, Michael Parra, Jose Julian Serna, Fernando Rodriguez, Alberto Garcia, Alexander Salcedo, Yaset Caicedo, Natalia Padilla, Luis Fernando Pino, Adolfo González, Mario Alain Herrera, Mauricio Millán, Laureano Quintero, Fabian Hernandez, Ricardo Ferrada, Megan Brenner, Todd Rasmussen, Thomas Scalea, Rao Ivatury, John Holcomb, Juan Pablo Herrera, Claudia Patricia Orlas, Monica Guzman, Maria Josefa Franco, Juan Carlos Salamea, Fernando Miñan, Wilmer Botache, Neftali Vargas, Rolando Medina, David Scavo, Cecibel Cevallos, Ana Milena del Valle, Jenny Marcela Vidal, Juan Jose Melendez, Edison Angamarca, Juliana Ordoñez, Carlos Serna, Christian Delgado, Helmer Emilio Palacios, Luis Saldarriaga, Carlos Munar, Luis Eduardo Toro, Gonzalo Aristizabal (Author)
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