Nguyễn Trường Giang, Trần Quốc Việt, Nguyễn Trung Kiên
Damage control resuscitation (DCR) is a modern resuscitative strategy for severely injured patients with hemorrhage, aimed at reducing early mortality through rapid hemorrhage control and early restoration of physiological stability. Based on current understanding of trauma-induced coagulopathy and the lethal triad, DCR emphasizes 7 core principles, including: Early hemorrhage control (prevent ongoing blood loss and maintain organ perfusion);Balanced transfusion (restore circulating volume and physiological coagulation capacity);Restriction of crystalloid fluids (avoid dilution of clotting factors, reduce tissue edema and microcirculatory disturbances);Temperature control (prevent hypothermia and reduce coagulopathy);Permissive hypotension (maintain perfusion of vital organs while minimizing re-bleeding);Goal-directed coagulation management (early detection and treatment of trauma-induced coagulopathy);Integration with damage control surgery (rapid control of bleeding sources and physiological stabilization). In modern warfare, characterized by a multi-echelon medical system and prolonged evacuation times, DCR plays a central role in maintaining physiological stability and ensuring continuity of casualty care from the point of injury to higher-level surgical facilities.
