tailieunhanh - Báo cáo khoa học: "Clinical review: Initial management of blunt pelvic trauma patients with haemodynamic instability"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Clinical review: Initial management of blunt pelvic trauma patients with haemodynamic instability. | Available online http content 11 1 204 Review Clinical review Initial management of blunt pelvic trauma patients with haemodynamic instability Thomas Geeraerts1 Vibol Chhor1 Gaelle Cheisson1 Laurent Martin1 Bertrand Bessoud2 Augustin Ozanne3 and Jacques Duranteau1 1 Departement d Anesthesie-Reanimation chirurgicale Centre Hospitalier Universitaire de Bicêtre Assistance Publique - Hôpitaux de Paris Univ Paris Sud Le Kremlin-Bicêtre France 2Service de radiologie générale et interventionnelle Centre Hospitalier Universitaire de Bicêtre Assistance Publique - Hôpitaux de Paris Univ Paris Sud Le Kremlin-Bicêtre France 3Service de neuroradiologie diagnostique et thérapeutique Centre Hospitalier Universitaire de Bicêtre Assistance Publique - Hôpitaux de Paris Univ Paris Sud Le Kremlin-Bicêtre France Corresponding author Thomas Geeraerts thgeeraerts@ Published 12 February 2007 Critical Care 2007 11 204 doi cc5157 This article is online at http content 11 1 204 2007 BioMed Central Ltd Abstract Pelvic trauma can lead to severe uncontrollable haemorrhage and death related to prolonged shock and multiple organ failure. Massive retroperitoneal haematoma should be assumed to be present in cases of post-traumatic haemodynamic instability associated with pelvic fracture in the absence of extrapelvic haemorrhagic lesions. This review describes the pathophysiology of retroperitoneal haematoma in trauma patient with blunt pelvic fracture considering the roles of venous and arterial bleeding. Efficacy and safety of haemostatic procedures are also discussed and particular attention is given to the efficacy of pelvic angiographic embolization and external pelvic fixation. A decision making algorithm is proposed for the treatment of trauma patients with pelvic fracture that takes haemodynamic status and associated lesions into account. Introduction The initial management of patients presenting with pelvic fracture and haemodynamic instability .