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Invited Commentary
September 2014

Resuscitation Is Better for Combat Casualty Outcomes: Now Let’s Forcefully Close the Performance Improvement Loop on Adverse Outcomes

Author Affiliations
  • 1University of Texas Health Science Center at Houston, Houston, Texas
JAMA Surg. 2014;149(9):913. doi:10.1001/jamasurg.2014.961

The study by Langan et al1 reviews the association between damage control resuscitation (DCR) and combat casualty outcomes over a 10-year period (2002-2011). Damage control resuscitation is a resuscitation guideline written and distributed in the Iraq war combat theater in 2005, and as Langan et al1 demonstrate in their study of 57 179 soldiers admitted to combat hospitals, improved hospital outcomes are associated with the broad adoption of this transfusion approach. While many changes occurred during this decade of war, perhaps the most significant was how resuscitation evolved. Crystalloid use plummeted, and a balanced approach to blood products transfusion became the norm. Langan et al1 state that “DCR is one of the most important medical breakthroughs of our current conflicts.”

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