Thoracic Damage Control Surgery

Purpose of Review: An overview of the practice of damage control surgery in the thoracic trauma patient with emphasis on physiological resuscitation and specific management principles of damage to different organs in the chest. Recent Findings: The advance of endovascular stents use for injuries of the large thoracic vessels can greatly assist in avoiding open surgery with major bleeding in a patient in physiological extremis. Extracorporeal membrane oxygenation (ECMO) can be used in those patients where conventional measures of resuscitation and oxygenation fail as an adjunct to restore normal physiology. Summary: Thoracic damage control surgery can be employed successfully if the physiology of the patient is paramount during resuscitation chasing the specific goals of reversing the lethal triad of acidosis, coagulopathy, and hypothermia. Abbreviated surgical techniques which mainly achieve hemostasis and control air leaks needs to be carefully employed in the thoracic cavity where packing of organs for hemostasis can greatly compromise cardiorespiratory reserve. © 2018, Springer International Publishing AG, part of Springer Nature.