BACKGROUND: In this retrospective study, we reviewed our protocol for management of hemodynamically unstable patients with pelvic injury. METHODS: We managed the patients with the same predetermined plan including controlled hemodynamic resuscitation with early use of vasopressors and pelvic angiography as a first-line treatment. RESULTS: Of 311 patients with pelvic fracture, 32 hemodynamically unstable patients (10.3%) underwent pelvic angiography, which was followed by embolization in 25 cases. Angiography was successful for 24 patients (96%) and extrapelvic bleeding was diagnosed in 5 patients (15%). Three of six laparotomies performed before angiography were nontherapeutic. One of seven laparotomies performed after angiography was negative. CONCLUSION: A protocol for management of patients with pelvic injury and hemodynamic instability that is associated with controlled resuscitation including vasopressor and early pelvic angioembolization is effective for treating pelvic hemorrhage and diagnosing extrapelvic hemorrhage. Further studies are needed to confirm the respective place of angiographic and surgical control of bleeding.
BACKGROUND: In this retrospective study, we reviewed our protocol for management of hemodynamically unstable patients with pelvic injury. METHODS: We managed the patients with the same predetermined plan including controlled hemodynamic resuscitation with early use of vasopressors and pelvic angiography as a first-line treatment. RESULTS: Of 311 patients with pelvic fracture, 32 hemodynamically unstable patients (10.3%) underwent pelvic angiography, which was followed by embolization in 25 cases. Angiography was successful for 24 patients (96%) and extrapelvic bleeding was diagnosed in 5 patients (15%). Three of six laparotomies performed before angiography were nontherapeutic. One of seven laparotomies performed after angiography was negative. CONCLUSION: A protocol for management of patients with pelvic injury and hemodynamic instability that is associated with controlled resuscitation including vasopressor and early pelvic angioembolization is effective for treating pelvic hemorrhage and diagnosing extrapelvic hemorrhage. Further studies are needed to confirm the respective place of angiographic and surgical control of bleeding.
Authors: Sophie Dunberry-Poissant; Kim Gilbert; Caroline Bouchard; Frédérique Baril; Anne-Marie Cardinal; Sydnée L'Ecuyer; Mathieu Hylands; François Lamontagne; Guy Rousseau; Emmanuel Charbonney Journal: Intensive Care Med Exp Date: 2018-11-12
Authors: Efthimios J Karadimas; Tony Nicolson; Despoina D Kakagia; Stuart J Matthews; Paula J Richards; Peter V Giannoudis Journal: Int Orthop Date: 2011-05-17 Impact factor: 3.075
Authors: Diederik O Verbeek; Diederik Verbeek; Michael Sugrue; Zsolt Balogh; Danny Cass; Ian Civil; Ian Harris; Thomas Kossmann; Steve Leibman; Valerie Malka; Anthony Pohl; Sudhakar Rao; Martin Richardson; Michael Schuetz; Caesar Ursic; Vanessa Wills Journal: World J Surg Date: 2008-08 Impact factor: 3.352
Authors: Igor Jeroukhimov; Itamar Ashkenazi; Boris Kessel; Vladimir Gaziants; Amir Peer; Alexander Altshuler; Vladimir Nesterenko; Ricardo Alfici; Ariel Halevy Journal: Scand J Trauma Resusc Emerg Med Date: 2009-11-29 Impact factor: 2.953