Peri-operative strategy in resuscitation of unstable injured surgical patients: a primer.

Autor:	Abdulkhaleq Mamalchi S; Royal College of Surgeons in Ireland Medical University of Bahrain, Adliya, Bahrain., Matar M; Division of General Surgery Trauma Services, Ottawa Hospital, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada., Bass GA; Division of Traumatology, Surgical Critical Care and Emergency Surgery, Medical Office Building Suite 120 (Trauma), Penn Presbyterian Medical Center, 54 N 39th Street, Philadelphia, PA, 19104, United States.
Jazyk:	angličtina
Zdroj:	Postgraduate medical journal [Postgrad Med J] 2024 Oct 14. Date of Electronic Publication: 2024 Oct 14.
DOI:	10.1093/postmj/qgae141
Abstrakt:	Background: Trauma remains a leading cause of death, both for individuals under 40 in North America, and globally, where it contributes to ~10% of deaths annually. Thoughtful, timely, balanced resuscitation, especially in the peri-operative period for unstable injured surgical patients, is vital for optimizing outcomes. The advanced trauma life support protocol plays a pivotal role in early evaluation and management, emphasizing hemorrhage control and resuscitation strategies. Objective: This narrative review provides a structured, evidence-based framework aimed at enhancing the educational experience of surgical trainees. It outlines key principles in peri-operative trauma resuscitation, emphasizing timely intervention, goal-directed fluid therapy, and damage control surgery (DCS) to improve patient outcomes. Methods: A comprehensive Scale for Quality Assessment of Narrative Review Articles -guideline compliant literature search was conducted using PubMed and Google Scholar for English-language articles published between January 2000 and February 2024. The search included relevant medical subject headings terms. Additional studies were identified from reference lists. Extracted data were reviewed and organized using thematic analysis, focusing on historical perspectives, evidence-based practices, and the concept of DCS. Results: Key findings from the 55 relevant studies selected underscore the importance of balanced fluid and blood product administration, the use of permissive hypotension in hemorrhagic shock, and the application of DCS principles. This review highlights educational strategies that foster a deeper understanding of trauma resuscitation practices, offering practical insights through case studies and technological innovations. Conclusion: This review serves as an educational resource for surgical trainees, equipping them with a robust understanding of evidence-based trauma resuscitation. By integrating historical context, modern practices, and emerging technologies, the review aims to enhance both the theoretical knowledge and practical skills necessary for managing unstable trauma patients. Emphasis is placed on interdisciplinary teamwork, continuous education, and personalized resuscitation strategies to improve clinical outcomes. (© The Author(s) 2024. Published by Oxford University Press on behalf of Fellowship of Postgraduate Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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