José Osvaldo Barbosa Neto1, Marcos Fernando Breda de Moraes2, Ricardo Souza Nani3, Joel Avancini Rocha Filho4, Maria José Carvalho Carmona5. 1. Anesthesiologist at Department of Anesthesia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP). Electronic address: osvbarbosa@yahoo.com.br. 2. Resident Physician at Department of Anesthesia, Hospital das Clínicas, FMUSP; Specialization in Anesthesiology, Centro de Ensino e Treinamento, Sociedade Brasileira de Anestesiologia (SBA). 3. TSA; Anestheiologist, at Department of Anesthesia, Hospital das Clínicas, FMUSP. 4. TSA; Anestheiologist, at Department of Anesthesia, Hospital das Clínicas, FMUSP; PHD in Medical Sciences, FMUSP. 5. TSA; Associate Professor, FMUSP.
Abstract
BACKGROUND AND OBJECTIVES: The aim of this paper is to report a case in which the damage control resuscitation (DCR) approach was successfully used to promote hemostatic resuscitation in a polytraumatized patient with severe hemorrhagic shock. CASE REPORT: Female patient, 32 years of age, with severe hemorrhagic shock due to polytrauma with hip fracture, who developed acidosis, coagulopathy, and hypothermia. During fluid resuscitation, the patient received blood products transfusion of fresh frozen plasma/packed red blood cells/platelet concentrate at a ratio of 1:1:1 and evolved intraoperatively with improvement in perfusion parameters without requiring vasoactive drugs. At the end of the operation, the patient was taken to the intensive care unit and discharged on the seventh postoperative day CONCLUSION: : The ideal management of traumatic hemorrhagic shock is not yet established, but the rapid control of bleeding and perfusion recovery and well-defined therapeutic protocols are fundamental to prevent progression of coagulopathy and refractory shock.
BACKGROUND AND OBJECTIVES: The aim of this paper is to report a case in which the damage control resuscitation (DCR) approach was successfully used to promote hemostatic resuscitation in a polytraumatized patient with severe hemorrhagic shock. CASE REPORT: Female patient, 32 years of age, with severe hemorrhagic shock due to polytrauma with hip fracture, who developed acidosis, coagulopathy, and hypothermia. During fluid resuscitation, the patient received blood products transfusion of fresh frozen plasma/packed red blood cells/platelet concentrate at a ratio of 1:1:1 and evolved intraoperatively with improvement in perfusion parameters without requiring vasoactive drugs. At the end of the operation, the patient was taken to the intensive care unit and discharged on the seventh postoperative day CONCLUSION: : The ideal management of traumatic hemorrhagic shock is not yet established, but the rapid control of bleeding and perfusion recovery and well-defined therapeutic protocols are fundamental to prevent progression of coagulopathy and refractory shock.