Pelvic Fracture Pattern Predicts Pelvic Arterial Haemorrhage

Hamill, James; Holden, Andrew; Paice, Rhondda; Civil, Ian

doi:10.1046/j.1440-1622.2000.01822.x

Cited by 107 publications

(64 citation statements)

References 37 publications

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“…Fracture pattern is reported to have good sensitivity but poor specificity for predicting the presence of significant arterial bleeders. [31][32][33] The presence of hemorrhagic shock without nonpelvic bleeding sources, transient responsiveness, and nonresponsiveness to the initial resuscitation with persistent acidosis requiring massive resuscitation are the most useful predictors of potentially therapeutic angioembolization. 30 Following this rationale, hemodynamically unstable patients with pelvic fracture and without other obvious sources of bleeding all should undergo PA within 90 minutes, according to the PG.…”

Section: Discussionmentioning

confidence: 99%

Institutional Practice Guidelines on Management of Pelvic Fracture-Related Hemodynamic Instability: Do They Make a Difference?

Balogh

Caldwell

Heetveld

et al. 2005

The Journal of Trauma: Injury, Infection, and Critical Care

137

106

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Section: Discussionmentioning

confidence: 99%

Institutional Practice Guidelines on Management of Pelvic Fracture-Related Hemodynamic Instability: Do They Make a Difference?

Balogh

Caldwell

Heetveld

et al. 2005

The Journal of Trauma: Injury, Infection, and Critical Care

137

106

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“…Some authors however report a relationship between the stability of the pelvic ring (irrespective of fracture mechanism) and identification of active arterial bleeding [14,[22][23][24].…”

Section: Classifications Of Pelvic Injuriesmentioning

confidence: 99%

Pelvic trauma and vascular emergencies

Scemama

Dabadie

Varoquaux

et al. 2015

Diagnostic and Interventional Imaging

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Pelvic ring injuries carry a high mortality rate, the main cause of which, in the first 24hours, is exsanguination. Injured patients are managed by a multidisciplinary damage-control strategy. Unstable patients should have instrumentalized hemostasis without delay. Arterial embolization is an effective way of achieving this and justifies this approach being permanently available in level 1 trauma-centers. After CT assessment of injuries, stable patients can undergo arterial embolization if active arterial bleeding or vascular damage is present. The embolization methods (selective or unselective) and agents used depend on the patient's hemodynamic stage and assessment of the injury whenever possible.

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“…Questa sequenza può essere controindicata da alcuni colleghi intensivisti in pazienti con elevato grado di instabilità emodinamica, ma l'utilizzo di un protocollo trasfusionale aggressivo con precoce somministrazione di fattori della coagulazione (rapporto FFP:PRBC di 1:1) [19] associato a una rapida manovra di chiusura e stabilizzazione della pelvi in emergenza con PIB o C-clamp [20], ha dimostrato nella pratica clinica di molti Autori [4,13,[21][22][23][24] essere il "gold standard" per ottenere una temporanea stabilizzazione fisiologica. Diviene così possibile la prosecuzione del protocollo diagnostico e in definitva il trattamento della lesione, che comunque rimane l'obiettivo finale del chirurgo d'urgenza che opera come "leader" del Trauma Team.…”

Section: Discussioneunclassified