SPECIFIC FEATURES OF THE RESUSCITATION PROCESS IN TRAUMATIC SHOCK CONDITIONS
Keywords:
Traumatic Shock, Damage Control Resuscitation (DCR), Hemostatic Resuscitation, Permissive Hypotension, Hemorrhage, Lethal Triad, Tranexamic Acid (TXA), Thromboelastography, Massive Transfusion Protocol (MTP), Coagulopathy.Abstract
Traumatic shock remains a leading cause of mortality in emergency medicine, demanding specialized resuscitation protocols that differ significantly from standard advanced life support. This article provides a comprehensive analysis of the pathophysiological peculiarities of traumatic shock, primarily hemorrhagic and distributive in nature, which necessitate a balanced, damage-control approach. The core principles of "Hypotensive Resuscitation," "Permissive Hypotension," and "Hemostatic Resuscitation" are critically examined. The discussion emphasizes the paradigm shift from aggressive crystalloid infusion to early, balanced transfusion of blood components (1:1:1 or 1:1:2 ratio of RBC:FFP:Platelets) and the use of tranexamic acid. Furthermore, the article integrates the latest evidence on bedside monitoring, including thromboelastography (TEG/ROTEM), and the central role of immediate hemorrhage control, whether surgical or endovascular. The conclusion underscores that resuscitation in traumatic shock is a time-sensitive, targeted physiological correction aimed at restoring tissue perfusion while mitigating the lethal triad of hypothermia, acidosis, and coagulopathy. Adherence to these specific protocols significantly improves survival and reduces complications.
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