Current trends in the management of hemodynamically unstable pelvic ring injuries.

Purpose Of Review: Complex traumatic pelvic ring disruptions are associated with a high mortality rate due to associated retroperitoneal hemorrhage, traumatic-hemorrhagic shock, and postinjury coagulopathy. The present review provides an update on current management strategies to improve survival ra...

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Publicado en:Current Opinion in Critical Care Vol. 23; no. 6; pp. 511 - 520
Autores principales: Stahel, Philip F., Burlew, Clay C., Moore, Ernest E.
Formato: review Journal Article
Publicado: Lippincott Williams & Wilkins Dec2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2017
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Current trends in the management of hemodynamically unstable pelvic ring injuries.
      aug:
        au:
          Stahel, Philip F.
          Burlew, Clay C.
          Moore, Ernest E.
        affil: Department of Orthopaedics and Neurosurgery, School of Medicine, Denver Health Medical Center, University of Colorado, Denver
      sug:
        subj:
          Blood Coagulation Disorders Therapy
          Retroperitoneal Space Injuries
          Resuscitation Methods
          Fractures Surgery
          Pelvic Bones Surgery
          Hemorrhage Therapy
          Hemodynamics
          Pelvic Bones Physiopathology
          Survival
          Fractures Complications
          Blood Coagulation Disorders Etiology
          Pelvic Bones Injuries
          Embolization, Therapeutic Methods
          Hemorrhage Etiology
          Hemorrhage Physiopathology
          Fracture Fixation Methods
          Blood Transfusion Methods
          Blood Coagulation Disorders Physiopathology
          Critical Path
      ab: Purpose Of Review: Complex traumatic pelvic ring disruptions are associated with a high mortality rate due to associated retroperitoneal hemorrhage, traumatic-hemorrhagic shock, and postinjury coagulopathy. The present review provides an update on current management strategies to improve survival rates form hemodynamically unstable pelvic ring injuries.Recent Findings: Recently published international consensus guidelines have attempted to standardize the classification of hemodynamically unstable pelvic ring injuries and provided classification-based management algorithms for acute resuscitation and pelvic ring stabilization.Summary: Acute management strategies for pelvic ring disruptions with associated hemorrhagic shock include resuscitative endovascular balloon occlusion of the aorta for patients 'in extremis' in conjunction with point-of-care guided resuscitation for postinjury coagulopathy. Recent data indicate that a protocol of early pelvic external fixation in conjunction with direct preperitoneal pelvic packing and subsequent angioembolization in patients with ongoing hemorrhage results in significantly improved survival from retroperitoneal exsanguinating hemorrhage in at-risk patients with historic mortality rates as high as 50-60%.
      pubtype: Academic Journal
      doctype:
        review
        Journal Article
      ougenre: Article
    language: English
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