బ్రిటిష్ జర్నల్ ఆఫ్ రీసెర్చ్ అందరికి ప్రవేశం

నైరూప్య

Damage Control Anaesthesia

M O Ababneh

Damagecontrol surgery (DCS) isaconcept of abbreviated laparotomy,designed toprioritize short-term physiological recovery over anatomical reconstruction in theseriously injured and compromised patient. Over the last 10 yrs., a new addition tothe damage control paradigm has emerged, referred to as damage controlresuscitation (DCR). This focuses on initial hypotensive resuscitation and earlyuse of blood products to limit or halt the progression of the lethal triad of acidosis, coagulopathy, andhypothermia. Involves postponing of definitive repair or fixation until the patient has been adequately resuscitated. DCS shifts the focus from anatomical to physiological restoration. Damage Control Anaesthesia (DCA) should include assisting the non-trauma surgical team recognise and appreciate the magnitude of haemorrhage and understand the need to maintain a dynamic plan. The aim of DCA must remain primarily the arresting of the lethal triad whilst ensuring cardio-respiratory stability as well as adequate analgesia and sedation. DCA has four phases, Phase one in the emergency department, phase two in the operating room, phase there and phase four in the definitive surgery. The role of the anesthesiologist in damage control trauma care is that of resuscitation consultant Most of the goals of DCA are part of the duties of trauma anaesthetist. DCA will have profound positive effects on morbidity and mortality