Strategies for the management of haemorrhage following pelvic fractures and associated trauma-induced coagulopathy
| Autor: | Clay Cothren Burlew, Philip F. Stahel, Ernest E. Moore, Cyril Mauffrey, Fredric M. Pieracci, E. M. Hammerberg, Derly O. Cuellar, David J. Hak |
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| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Resuscitation medicine.medical_treatment Hemorrhage Fractures Bone External fixation Fracture Fixation Coagulopathy medicine Humans Blood Transfusion Orthopedics and Sports Medicine In patient Pelvic Bones Intensive care medicine Hemostatic Techniques business.industry Blood Coagulation Disorders medicine.disease Thrombelastography Surgery Severe trauma Haemodynamic instability Pelvic fracture business Trauma induced coagulopathy |
| Zdroj: | The Bone & Joint Journal. :1143-1154 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.96b9.33914 |
| Popis: | Exsanguination is the second most common cause of death in patients who suffer severe trauma. The management of haemodynamically unstable high-energy pelvic injuries remains controversial, as there are no universally accepted guidelines to direct surgeons on the ideal use of pelvic packing or early angio-embolisation. Additionally, the optimal resuscitation strategy, which prevents or halts the progression of the trauma-induced coagulopathy, remains unknown. Although early and aggressive use of blood products in these patients appears to improve survival, over-enthusiastic resuscitative measures may not be the safest strategy. This paper provides an overview of the classification of pelvic injuries and the current evidence on best-practice management of high-energy pelvic fractures, including resuscitation, transfusion of blood components, monitoring of coagulopathy, and procedural interventions including pre-peritoneal pelvic packing, external fixation and angiographic embolisation. Cite this article: Bone Joint J 2014; 96-B:1143–54. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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