Resumo

ORDONEZ, Carlos A. et al. Damage control resuscitation: REBOA as the new fourth pillar. Colomb. Med. [online]. 2020, vol.51, n.4, e4014353.  Epub 07-Dez-2020. ISSN 1657-9534.  https://doi.org/10.25100/cm.v51i4.4353.

Damage Control Resuscitation (DCR) seeks to combat metabolic decompensation of the severely injured trauma patient by battling on three major fronts: Permissive Hypotension, Hemostatic Resuscitation, and Damage Control Surgery (DCS). The aim of this article is to perform a review of the history of DCR/DCS and to propose a new paradigm that has emerged from the recent advancements in endovascular technology: The Resuscitative Balloon Occlusion of the Aorta (REBOA). Thanks to the advances in technology, a bridge has been created between Pre-hospital Management and the Control of Bleeding described in Stage I of DCS which is the inclusion and placement of a REBOA. We have been able to show that REBOA is not only a tool that aids in the control of hemorrhage, it is also a vital tool in the hemodynamic resuscitation of a severely injured blunt and/or penetrating trauma patient. That is why we propose a new paradigm “The Fourth Pillar”: Permissive Hypotension, Hemostatic Resuscitation, Damage Control Surgery and REBOA.

Palavras-chave : Hemorrhage; Shock; Damage Control Resuscitation; REBOA.

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