Damage control surgery is defined as rapid termination of an operation after control of life threatening bleeding and contamination in severely injured and unstable patients, followed by correction of physiologic abnormalities and de-finitive management. Emphasis then shifts from the operating theater to the intensive care unit, where the patient’s physiologic deficits are corrected.

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The ability of the cerebral vascular bed to undergo constriction or dilation in response to various stimuli is termed vascular reactivity or cerebral autoregulation. When the stimulus is the change in cerebral perfusion pressure (CPP) the vascular response is termed cerebrovascular pressure reactivity. When the stimulus is the change in PaCO2 the vascular response is termed carbon dioxide reactivity. The transcranial Doppler (TCD) provides information about changes in flow velocities secondary to changes in CPP or PaCO2.

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