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Trauma Resuscitation

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Penetrating Trauma

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Abstract

Hemorrhage, as both a disease of decreased perfusion and a disease of altered immunity, accounts for up to 40% of trauma-related deaths. In both civilian and military settings, many of these deaths may be preventable. The majority of hemorrhage-related deaths occur in the first 6 h after injury. Hemorrhage leads to systemic hypotension, decreased end-organ perfusion, tissue hypoxia, and free-radical injury in the first few hours. However, delayed deaths are due to hemorrhage-triggered secondary messenger modulation, gene expression, and neutrophil activation that make the host susceptible to the posttraumatic multiorgan failure and sepsis that account for the majority of late deaths after trauma. In the face of trauma, the means to improve survival is expeditious hemorrhage control and minimizing soft tissue secondary injury. Resuscitation is the key to minimize secondary soft tissue/organ injury but is not meant to be a surrogate for hemorrhage control. This chapter will focus on the resuscitation component of acute trauma care.

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Author information

Authors and Affiliations

  1. Trauma, Critical Care, University of Massachusetts Medical School, UMassMemorial Medical Center, 55 Lake Avenue North, Worcester, MA, 01655, USA

    Heena P. Santry

  2. Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge Street, Suite 810, Boston, MA, 02114, USA

    Marc de Moya

Authors
  1. Heena P. Santry
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  2. Marc de Moya
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Corresponding author

Correspondence to Heena P. Santry .

Editor information

Editors and Affiliations

  1. Dept. Surgery, Massachusetts General Hospital, Fruit Street 55, Boston, 02114, Massachusetts, USA

    George C. Velmahos

  2. Medical School, Dept. Surgery, University of Witwatersrand, York Road 7, Johannesburg, 2193, South Africa

    Elias Degiannis

  3. Klinik für Viszeral-, Thorax- und, Gefäßchirurgie, Univ.Klinikum Marburg, Baldingerstraße, Marburg, 35043, Germany

    Dietrich Doll

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© 2012 Springer Berlin Heidelberg

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Santry, H.P., de Moya, M. (2012). Trauma Resuscitation. In: Velmahos, G., Degiannis, E., Doll, D. (eds) Penetrating Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-20453-1_7

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  • DOI: https://doi.org/10.1007/978-3-642-20453-1_7

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-20452-4

  • Online ISBN: 978-3-642-20453-1

  • eBook Packages: MedicineMedicine (R0)

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