Achieving balanced transfusion early in critically bleeding trauma patients: an observational study exploring the effect of attending trauma surgical presence during resuscitation.

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Abstract

Conflict of interest statement: Competing interests: None declared. 6. Chirurg. 2013 Sep;84(9):759-63. doi: 10.1007/s00104-013-2478-z. [Operative treatment strategies for multiple trauma patients : early total care versus damage control]. [Article in German] Klüter T(1), Lippross S, Oestern S, Weuster M, Seekamp A. Author information: (1)Klinik für Unfallchirurgie (Traumatologie), Traumazentrum Nord, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland, Tim.Klueter@uksh.de. The treatment of multiple trauma patients is a great challenge for an interdisciplinary team. After preclinical care and subsequent treatment in the emergency room the order of the interventions is prioritized depending of the individual risk stratification. For planning the surgery management it is essential to distinguish between absolutely essential operations to prevent life-threatening situations for the patient and interventions with shiftable indications, depending on the general condition of the patient. All interventions need to be done without causing significant secondary damage to prohibit hyperinflammation and systemic inflammatory response syndrome. The challenge consists in determination of the appropriate treatment at the right point in time. In general the early primary intervention, early total care, is differentiated from the damage control concept. DOI: 10.1007/s00104-013-2478-z