Damage Control Resuscitation: Directly Addressing the Early Coagulopathy of Trauma

Rapid progress in trauma care occurs when the results of translational research are promptly integrated into clinical practice. Experience with a high volume of severely injured casualties expedites the process.1 Historically, these conditions have converged during times of conflict, improving the care of combat casualties and subsequently that of civilian trauma patients.1,2 In the most severely injured casualties, we know that when the lethal triad of hypothermia, acidosis, and coagulopathy are present, death is imminent.3 Current teaching is to avoid reaching these conditions by using “damage control surgery.”4–6 However, conventional resuscitation practice for damage control focuses on rapid reversal of…