{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:45:23Z","timestamp":1790250323622,"version":"4.1.0"},"reference-count":63,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009687","name":"Wroclaw Medical University\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t              https:\/\/ror.org\/01qpw1b93","doi-asserted-by":"publisher","award":["SUBZ.A120.26.014"],"award-info":[{"award-number":["SUBZ.A120.26.014"]}],"id":[{"id":"10.13039\/501100009687","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Damage Control Resuscitation (DCR) is a critical strategy in the management of severe trauma, focusing on the optimisation of the patient\u2019s physiological condition. This study reviews current DCR strategies, emphasizing the mitigation of the \u201cdiamond of death\u201d\u2014hypothermia, acidosis, coagulopathy, and hypocalcemia\u2014while addressing complex disturbances like respiratory distress syndrome (ARDS) and (acute kidney injury) AKI in high-ISS (Injury Severity Score) patients. Methods: A systematic review of 59 contemporary sources was conducted, encompassing clinical trials (e.g., CRASH-2), military-to-civilian protocol translations, and guidelines from the C and European Resuscitation Council. The analysis focused on pre-hospital interventions, in-hospital transfusion protocols, and the impact of transport logistics on survival. Results: Evidence highlights that aggressive crystalloid resuscitation (over 5 L) significantly increases mortality, favoring balanced blood component therapy (1:1:1 ratio) or Whole Blood guided by viscoelastic testing like rotational thromboelastometry (ROTEM) or thromboelastography (TEG). Pre-hospital success is driven by rapid hemorrhage control via tourniquets, early administration of Tranexamic Acid (TXA), no aggressive crystalloids, permissive hypotension, proactive calcium supplementation is recommended in early care. Furthermore, the integration of Helicopter Emergency Medical Services (HEMS) is independently associated with improved survival in multi-organ trauma by reducing time to definitive care and facilitating \u201cen-route\u201d damage control. Conclusions: The evolution of rescue strategies focused on mitigating the effects of the diamond of death, combined with the implementation of permissive hypotension and optimized HEMS logistics, constitutes the foundation of a modern model aimed at minimizing mortality in multi-organ trauma.<\/jats:p>","DOI":"10.3390\/jcm15072549","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:12:25Z","timestamp":1774609945000},"page":"2549","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Importance of the \u201cDamage Control\u201d Strategy in Multiple Organ Injuries, Pathophysiology and Principles of Hemorrhage Control"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9764-4666","authenticated-orcid":false,"given":"Oliwia","family":"Klimek","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Wroclaw Medical University, 51-601 Wroclaw, Poland"},{"name":"Student Scientific Association of Emergency and Critical Care Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7111-887X","authenticated-orcid":false,"given":"Jakub","family":"Dudek","sequence":"additional","affiliation":[{"name":"Lower Silesian Specialist Hospital\u2014Centre for Emergency Medicine, ul. Gen. Augusta Emila Fieldorfa 2, 54-049 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Czesyk","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Wroclaw Medical University, 51-601 Wroclaw, Poland"},{"name":"Student Scientific Association of Emergency and Critical Care Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartosz","family":"Sierant","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Wroclaw Medical University, 51-601 Wroclaw, Poland"},{"name":"Student Scientific Association of Emergency and Critical Care Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7591-8340","authenticated-orcid":false,"given":"Wiktoria","family":"G\u00f3recka","sequence":"additional","affiliation":[{"name":"University Centre of Dentistry, Krakowska 26, 50-425 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1806-9028","authenticated-orcid":false,"given":"Grzegorz","family":"Gogolewski","sequence":"additional","affiliation":[{"name":"Clinical Department of Emergency Medicine, Faculty of Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland"},{"name":"Emergency Department, Jan Mikulicz Radecki University Hospital in Wroclaw, Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0110-0276","authenticated-orcid":false,"given":"Tomasz","family":"Jurek","sequence":"additional","affiliation":[{"name":"Battlefield Medicine and Forensic Ballistics Laboratory, Department of Forensic Medicine, Faculty of Medicine, Wroclaw Medical University, Jana Mikulicza-Radeckiego 4, 50-345 Wroclaw, Poland"},{"name":"Emergency Department, Jan Mikulicz Radecki University Hospital in Wroclaw, Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuzanna","family":"Ochocka","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Wroclaw Medical University, 51-601 Wroclaw, Poland"},{"name":"Student Scientific Association of Emergency and Critical Care Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Jankowska","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Wroclaw Medical University, 51-601 Wroclaw, Poland"},{"name":"Student Scientific Association of Emergency and Critical Care Medicine, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1136\/jramc-153-04-16","article-title":"Damage control resuscitation","volume":"153","author":"Hodgetts","year":"2007","journal-title":"J. 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