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

doi:10.25100/cm.v51i4.4353

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 journal › Review article › peer-review

23 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 contribution	Damage control resuscitation: Reboa as the new fourth pillar
Original language	English
Article number	e-4014353
Pages (from-to)	1-12
Number of pages	12
Journal	Colombia Medica
Volume	51
Issue number	4
DOIs	https://doi.org/10.25100/cm.v51i4.4353
State	Published - 2020
Externally published	Yes

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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10.25100/cm.v51i4.4353

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Ordoñez, C. A., Parra, M. W., Serna, J. J., Rodríguez-Holguin, F., García, A., Salcedo, A., Caicedo, Y., Padilla, N., Pino, L. F., Hadad, A. G., Herrera, M. A., Lozano, M. M., Quintero-Barrera, L., Hernández-Medina, F., Ferrada, R., Brenner, M., Rasmussen, T., Scalea, T., Ivatury, R., & Holcomb, J. B. (2020). Damage control resuscitation: Reboa as the new fourth pillar. Colombia Medica, 51(4), 1-12. Article e-4014353. https://doi.org/10.25100/cm.v51i4.4353

@article{b4c2eb25425645a38e38e028f161951d,

title = "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.",

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

author = "Ordo{\~n}ez, {Carlos A.} and Parra, {Michael W.} and Serna, {Jos{\'e} Juli{\'a}n} and Fernando Rodr{\'i}guez-Holguin and Alberto Garc{\'i}a and Alexander Salcedo and Yaset Caicedo and Natalia Padilla and Pino, {Luis Fernando} and Hadad, {Adolfo Gonz{\'a}lez} and Herrera, {Mario Alain} and Lozano, {Mauricio Mill{\'a}n} and Laureano Quintero-Barrera and Fabian Hern{\'a}ndez-Medina and Ricardo Ferrada and Megan Brenner and Todd Rasmussen and Thomas Scalea and Rao Ivatury and Holcomb, {John B.}",

note = "Publisher Copyright: {\textcopyright} 2020 Universidad del Valle.",

year = "2020",

doi = "10.25100/cm.v51i4.4353",

language = "English",

volume = "51",

pages = "1--12",

journal = "Colombia Medica",

issn = "0120-8322",

number = "4",

}

Ordoñez, CA, Parra, MW, Serna, JJ, Rodríguez-Holguin, F, García, A, Salcedo, A, Caicedo, Y, Padilla, N, Pino, LF, Hadad, AG, Herrera, MA, Lozano, MM, Quintero-Barrera, L, Hernández-Medina, F, Ferrada, R, Brenner, M, Rasmussen, T, Scalea, T, Ivatury, R & Holcomb, JB 2020, 'Damage control resuscitation: Reboa as the new fourth pillar', Colombia Medica, vol. 51, no. 4, e-4014353, pp. 1-12. https://doi.org/10.25100/cm.v51i4.4353

TY - JOUR

T1 - Damage control resuscitation

T2 - Reboa as the new fourth pillar

AU - Ordoñez, Carlos A.

AU - Parra, Michael W.

AU - Serna, José Julián

AU - Rodríguez-Holguin, Fernando

AU - García, Alberto

AU - Salcedo, Alexander

AU - Caicedo, Yaset

AU - Padilla, Natalia

AU - Pino, Luis Fernando

AU - Hadad, Adolfo González

AU - Herrera, Mario Alain

AU - Lozano, Mauricio Millán

AU - Quintero-Barrera, Laureano

AU - Hernández-Medina, Fabian

AU - Ferrada, Ricardo

AU - Brenner, Megan

AU - Rasmussen, Todd

AU - Scalea, Thomas

AU - Ivatury, Rao

AU - Holcomb, John B.

PY - 2020

Y1 - 2020

N2 - 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.

AB - 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.

KW - Advanced trauma life support care

KW - Damage control resuscitation

KW - Damage control surgery

KW - Fibrinogen

KW - Hypothermia

KW - Intra-abdominal hypertension

KW - REBOA

KW - Thrombelastography

KW - Tourniquets

KW - Trauma centers

KW - Triage

UR - http://www.scopus.com/inward/record.url?scp=85100640891&partnerID=8YFLogxK

U2 - 10.25100/cm.v51i4.4353

DO - 10.25100/cm.v51i4.4353

M3 - Review article

C2 - 33795897

AN - SCOPUS:85100640891

SN - 0120-8322

VL - 51

SP - 1

EP - 12

JO - Colombia Medica

JF - Colombia Medica

IS - 4

M1 - e-4014353

ER -

Damage control resuscitation: Reboa as the new fourth pillar

Abstract

Keywords

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