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Review
. 2007;11(1):204.
doi: 10.1186/cc5157.

Clinical review: initial management of blunt pelvic trauma patients with haemodynamic instability

Thomas Geeraerts  1 , Vibol Chhor, Gaëlle Cheisson, Laurent Martin, Bertrand Bessoud, Augustin Ozanne, Jacques Duranteau
Affiliations
Review

Clinical review: initial management of blunt pelvic trauma patients with haemodynamic instability

Thomas Geeraerts et al. Crit Care. 2007.

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.

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Figures

Figure 1
Figure 1
Anatomical description of main pelvic arteries and veins.
Figure 2
Figure 2
Institutional decision-making algorithm for initial management of blunt pelvic trauma patients. CT, computed tomodensitometry; FAST, focused assessment with sonography for trauma; ICU, intensive care unit; TAP, thoracic-abdominal-pelvic.
See this image and copyright information in PMC

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