Damage control resuscitation: Reboa as the new fourth pillar

Translated title of the contribution: Damage control resuscitation: Reboa as the new fourth pillar

Carlos A. Ordoñez*, Michael W. Parra, José Julián Serna, Fernando Rodríguez-Holguin, Alberto García, Alexander Salcedo, Yaset Caicedo, Natalia Padilla, Luis Fernando Pino, Adolfo González Hadad, Mario Alain Herrera, Mauricio Millán Lozano, Laureano Quintero-Barrera, Fabian Hernández-Medina, Ricardo Ferrada, Megan Brenner, Todd Rasmussen, Thomas Scalea, Rao Ivatury, John B. Holcomb

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations

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.

Translated title of the contributionDamage control resuscitation: Reboa as the new fourth pillar
Original languageEnglish
Article numbere-4014353
Pages (from-to)1-12
Number of pages12
JournalColombia Medica
Volume51
Issue number4
DOIs
StatePublished - 2020
Externally publishedYes

Keywords

  • Advanced trauma life support care
  • Damage control resuscitation
  • Damage control surgery
  • Fibrinogen
  • Hypothermia
  • Intra-abdominal hypertension
  • REBOA
  • Thrombelastography
  • Tourniquets
  • Trauma centers
  • Triage

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