Prospective validation of a new protocol with preperitoneal pelvic packing as the mainstay for the treatment of hemodynamically unstable pelvic trauma: a 5-year experience.
Purposes: Hemodynamically unstable pelvic trauma has been a significant challenge even in most experienced Trauma Centres. In 2011 preperitoneal pelvic packing (PPP) was introduced in our Hospital as the first manoeuvre. This study aims to review overall mortality at 24 h from arrival in the emergen...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 47; no. 2; pp. 499 - 506 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Apr2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=149594431&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149594431 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Apr2021 vid: 47 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 149594431 144154775 149594431 149594431 10.1007/s00068-019-01115-3 149594431 ppf: 499 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Prospective validation of a new protocol with preperitoneal pelvic packing as the mainstay for the treatment of hemodynamically unstable pelvic trauma: a 5-year experience. aug: au: Magnone, Stefano Allievi, Niccolò Ceresoli, Marco Coccolini, Federico Pisano, Michele Ansaloni, Luca affil: General Surgery I, Ospedale Papa Giovanni XXIII, Piazza OMS 1, 24127, Bergamo, Italy sug: subj: Mortality Evaluation Pelvic Fractures Surgery Hemorrhage Surgery Hemostatic Techniques Methods Hemodynamics Emergency Service Human Female Male Adult Middle Age Aged Retrospective Design Record Review Systolic Pressure Erythrocytes Questionnaires Heart Rate Time Factors Angiography Trauma Variable Mann-Whitney U Test Descriptive Statistics Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Female Male ab: Purposes: Hemodynamically unstable pelvic trauma has been a significant challenge even in most experienced Trauma Centres. In 2011 preperitoneal pelvic packing (PPP) was introduced in our Hospital as the first manoeuvre. This study aims to review overall mortality at 24 h from arrival in the emergency department. Methods: A retrospective review of our prospective database was performed considering patients with systolic blood pressure (SBP) < 90 mmHg or with the need for more than 2 Units of packed red blood cells (PRBC) on admission in the emergency department, (ED) and a pelvic fracture. Values were expressed as a median and interquartile range. Continuous variables were compared with the Mann–Whitney test. Results: Between September 2011 and December 2016, we treated 30 patients. Median age was 51 years (40–65) and Injury Severity Score 36 (34–42). SBP in the ED was 90 (67–99), heart rate was 115 (90–130), Base Excess − 8 (− 11.5/− 4.8), pH 7.23 (7.20–7.28). Median PRBC requirements during the first 24 h (from admission) were 13 Units (8–18.8). Time to emergency treatment was 63 min (51–113). 17 patients (56.6%) underwent angiography after PPP. Overall 24 h mortality was 30%. A comparison between survivors and non-survivors showed no statistically significant differences between groups. Conclusions: In our experience, PPP resulted to be quick to perform and effective. No death occurred from direct pelvic bleeding. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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