**9.3 Damage control phase II (DCII)**

DCII involves taking the patient to the ICU postoperatively, where the goal is to restore the biochemical and physiological derangements. Managing fluid administration to bring the patient back to hemodynamic stability is often achieved through invasive monitoring (i.e., transthoracic echocardiography, transesophageal Doppler, pulmonary artery catheterization, etc.) [30]. Securing adequate oxygenation and aggressive rewarming of the patient are also necessary. The management of coagulopathy is crucial for survival, and the use of rotational thromboelastometry and other tests to assess how the coagulation cascade works along with massive blood transfusion practices have led to an improvement in outcomes and a decrease in blood transfusion requirements [30, 57]. Prevention of potentially fatal complications commonly seen in the ICU, including infection, adult respiratory distress syndrome, and deep vein thrombosis, is also important for patient survival [29]. This is the perfect opportunity for treating physicians to perform a complete reassessment of the patient and a "tertiary survey", including imaging studies that may help identify previously unknown injuries.
