Damage Control Anesthesia

Sugeir, Shihab; Grunstein, Itamar; Tobin, Joshua M.

doi:10.1007/978-3-319-72607-6_16

Cited by 2 publications

(4 citation statements)

References 53 publications

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“…Based on the DC concept, anesthesiologists play a crucial role in trauma care by collaborating closely with the surgical team to ensure optimal surgical conditions during DC surgery and correct any physiological imbalances under DC resuscitation with the aim of maintaining adequate perfusion to vital organs. This involves not only performing procedural tasks, such as airway management and vascular access, but also providing comprehensive anesthesia care, including vigilant monitoring of coagulation status and perfusion as well as massive transfusions and coagulation management [ 5 ].…”

Section: Damage Control Anesthesiamentioning

confidence: 99%

“…Damage control (DC) anesthesia is a critical component of the comprehensive care provided to patients undergoing DC surgery for acute severe trauma [ 5 ], which addresses the hemodynamic challenges of extensive hemorrhage and focuses on appropriate coagulation management in response to trauma-induced coagulopathy (TIC), a unique physiological response to trauma [ 2 ]. Recent advancements have demonstrated various pathophysiological mechanisms for TIC and have introduced goal-directed coagulation management as an alternative to traditional ratio therapy [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Revolutionizing trauma care: advancing coagulation management and damage control anesthesia

Kwon,

2024

Anesth Pain Med

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Despite advances in emergency transfer systems and trauma medicine, the incidence of preventable deaths due to massive hemorrhage remains high. Recent immunological research has elucidated key mechanisms underlying trauma-induced coagulopathy in the early stages of trauma, including sympathoadrenal stimulation, shedding of the glycocalyx, and endotheliopathy. Consequently, the condition progresses to fibrinogen depletion, hyperfibrinolysis, and platelet dysfunction. Coexisting factors such as uncorrected acidosis, hypothermia, excessive crystalloid administration, and a history of anticoagulant use exacerbate coagulopathy. This study introduces damage-control anesthetic management based on recent insights into damage-control resuscitation, emphasizing the importance of rapid transport, timely bleeding control, early administration of antifibrinolytics and fibrinogen concentrates, and maintenance of calcium levels and body temperature. Additionally, this study discusses brain-protective strategies for trauma patients with brain injuries and the utilization of cartridge-based viscoelastic assays for goal-directed coagulation management in trauma settings. This comprehensive approach may provide potential insights for anesthetic management in the fast-paced field of trauma medicine.

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Section: Damage Control Anesthesiamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Revolutionizing trauma care: advancing coagulation management and damage control anesthesia

Kwon,

2024

Anesth Pain Med

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“…The exception to permissive hypotension in DCS are patients with neurologic trauma such as traumatic brain injury or spinal cord injury. Recommendations are to maintain a MAP of 65 mmHg or a systolic blood pressure of 90-100 mmHg to maintain adequate cerebral perfusion pressure ranging from 60 to 70 mmHg [68,71].…”

Section: Damage Control Surgerymentioning

confidence: 99%

“…There are no specific recommendations regarding propofol versus dexmedetomidine or benzodiazepines with narcotic titrations. Rather, sedation for these patients should be individualized based on their clinical pathology and condition [71]. Benzodiazepines, while possessing a stable hemodynamic profile, should be used with significant caution in the elderly and in patients with renal failure [74].…”

Section: Considerations For Postoperative Carementioning

confidence: 99%

Anesthesiology for Trauma Medicine: Roles, Medications, Airway Management, and Multidisciplinary Team Coordination

Reese¹,

Bauerle²,

Allsbrook³

et al. 2023

Updates in Anesthesia - The Operating Room and Beyond

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Given the complex nature of trauma, a highly organized, multidisciplinary approach is necessary to ensure the best possible outcomes. Anesthesia providers play a critical role in the management and effective treatment of trauma patients. This chapter will address both the multidisciplinary and multitiered management of trauma patients with a focus on the intersection of trauma staff and anesthesia in three phases: the initial evaluation (i.e., in the bay), intraoperative care, and postoperative care. Included is a brief discussion on more recent methodologies and newly incorporated technologies in the resuscitation of trauma patients.

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Damage Control Anesthesia

Cited by 2 publications

References 53 publications

Revolutionizing trauma care: advancing coagulation management and damage control anesthesia

Revolutionizing trauma care: advancing coagulation management and damage control anesthesia

Anesthesiology for Trauma Medicine: Roles, Medications, Airway Management, and Multidisciplinary Team Coordination

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