Patients with hemodynamic unstable pelvic fractures in extremis: pelvic packing or angiography?

The multidisciplinary management of patients with pelvic trauma has improved prognosis, but mortality is still very high. The appropriate treatment strategy remains controversial, especially regarding the control of bleeding in patients whose clinical situation is extreme by using angiography or pel...

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Bibliographic Details
Published in:Revista española de cirugía ortopédica y traumatología 2013-11, Vol.57 (6), p.429-433
Main Authors: Liñán-Padilla, A, Giráldez-Sánchez, M Á, Serrano-Toledano, D, Lázaro-Gonzálvez, A, Cano-Luís, P
Format: Article
Language:eng ; spa
Subjects:
Angiography
Clinical Protocols
Embolization, Therapeutic - methods
Fractures, Bone - complications
Fractures, Bone - physiopathology
Hemodynamics
Hemorrhage - etiology
Hemorrhage - therapy
Humans
Pelvic Bones - injuries
Severity of Illness Index
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Summary:The multidisciplinary management of patients with pelvic trauma has improved prognosis, but mortality is still very high. The appropriate treatment strategy remains controversial, especially regarding the control of bleeding in patients whose clinical situation is extreme by using angiography or pelvic packing. We propose using a tool of evidence-based medicine (CAT) the benefit of the completion of pelvic packing in relation to a specific clinical question from a specific situation. What is best for the management of bleeding, extraperitoneal pelvic packing or angiography, in patients with hemodynamically unstable pelvic fracture in extremis? From this study we can conclude that angiography may improve control of bleeding in patients with arterial bleeding and hemodynamically stable but the packing has priority in patients with pelvic fractures and hemodynamic instability.
ISSN:1988-8856
1988-8856
DOI:10.1016/j.recote.2013.11.003