Transfusión masiva: un abordaje desde el protocolo de control de daños

Massive hemorrhage is one of the main causes of death in the critically ill patient, especially in the emergency department, being the transfusion of hemocomponents a very important strategy to save the life of these patients. Massive transfusion protocols were created to ensure that these patients receive blood components efficiently. Damage control resuscitation aims to rapidly control hemorrhage and prevent or treat if applicable the lethal triad of hypothermia, acidosis and coagulopathy; for this, three strategies were established: hemodynamic resuscitation by restrictive fluid therapy, permissive hypotension and massive transfusion, metabolic resuscitation and hemostatic resuscitation protocol. The damage control protocol has demonstrated benefits and a reduction in the risk of mortality in patients with massive hemorrhage; however, it requires multidisciplinary work and adequate coordination among the services involved in the process.