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European Journal of Trauma and Emergency Surgery

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06.04.2019 | Original Article

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

verfasst von: Stefano Magnone, Niccolò Allievi, Marco Ceresoli, Federico Coccolini, Michele Pisano, Luca Ansaloni

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 2/2021

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Abstract

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.

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Titel: 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
verfasst von: Stefano Magnone
Niccolò Allievi
Marco Ceresoli
Federico Coccolini
Michele Pisano
Luca Ansaloni
Publikationsdatum: 06.04.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 2/2021
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-019-01115-3

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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