scholarly journals The clinical effectiveness of permissive hypotension in blunt abdominal trauma with hemorrhagic shock but without head or spine injuries or burns: a systematic review

2012 ◽  
pp. 21 ◽  
Author(s):  
Abdulrahman Alsawadi
Keyword(s):  
Systematic Review ◽  
Hemorrhagic Shock ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Clinical Effectiveness ◽  
Permissive Hypotension ◽  
Spine Injuries

Anesthetic management of a patient with hollow viscus perforation due to blunt abdominal trauma with grade IV hemorrhagic shock

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Reza Widianto Sudjud ◽  
Djoni Kusumah Pohan ◽  
Muhammad Budi Kurniawan ◽  
Hana Nur Ramila
Keyword(s):  
Hemorrhagic Shock ◽  
Blunt Abdominal Trauma ◽  
Massive Transfusion ◽  
Damage Control ◽  
Anesthetic Management ◽  
Hollow Viscus ◽  
Permissive Hypotension ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol ◽  
Hollow Viscus Perforation

Hemorrhagic shock is a form of hypovolemic shock in which severe blood loss leads to inadequate oxygen delivery at the cellular level. Death from hemorrhage represents a substantial global problem, with more than 60,000 deaths per year in the United States and an estimated 1.9 million deaths per year worldwide, 1.5 million of which result from physical trauma. This case report aims to stress the need of handling cases of hemorrhagic shock in accordance with damage control protocol. Hemorrhagic shock management using permissive hypotension management, bleeding control, massive transfusion protocol (MTP), minimal crystalloid therapy, and adjuvant therapy is the best approach to get optimal outcome to prevent triad of death. In this case, the application of damage control resuscitation has not been fully implemented because of several constraints. Key words: Hemorrhage; Hemorrhagic shock; Permissive hypotension; Massive Transfusion Protocol; MTP; Resuscitation; Damage control Citation: Pohan DK, Sudjud RW, Kurniawan MB, Ramila HN. Anesthetic management on patient with hollow viscus perforation due to blunt abdominal trauma with grade IV hemorrhagic shock. Anaesth. pain intensive care 2021;25(2):217-221. DOI: 10.35975/apic.v25i2.1474 Received: 11 January 2021, Reviewed: 15 January 2021, Accepted: 16 February 2021

scholarly journals Lactate clearance: its relationship with the success of non-operative management in patient with blunt abdominal trauma

2017 ◽  
Vol 4 (5) ◽  
pp. 1738
Author(s):  
Reno Rudiman ◽  
Nova Saragih ◽  
Andriana Purnama
Keyword(s):  
Hemorrhagic Shock ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Operative Management ◽  
Lactate Clearance ◽  
Trauma Patients ◽  
Solid Organ ◽  
Chi Square ◽  
History Of ◽  
Non Operative Management

Background: Occult ongoing bleeding has become the second highest cause of death in blunt abdominal trauma. Undetected abdominal injury has caused morbidity and mortality in patients at the early phases of trauma. Non-operative Management (NOM) in solid organ trauma is safe and effective, and this strategy has become widely used. Lactate clearance (LC) has important clinical benefits in patients with acute trauma that is superior to initial lactate examination.  Methods: This study was a prospective cohort study of patients with history of hemorrhagic shock caused by blunt abdominal trauma that came to emergency room of Hasan Sadikin Hospital Bandung from August 2015 to July 2016. The tests were including initial blood lactate, 2 hours, and 4 hours post-resuscitation and then calculation of LC. Analysis using SPSS with chi square for the significance of relationships and Spearman correlation to determine the strength of the relationship between variables. Comparison test between LC2 and LC4 were calculated using Mann-Whitney tests.Results: During one year period, from August 2015 to July 2016, there were 34 patients. Age was in the range of 15-65 years, with a range of 15-25 years were 19 (55.8%), 25-50 years were 11 (32.4%), and >50 years as many as four (11.8%). By sex, there were 28 (82.4%) male gender and 6 (17.6%) women. Based on the type of trauma, there were 11 (32.4%) single trauma patients and 23 (67.6%) multiple trauma patients. Based on the results of statistical analysis with chi square, there was a significant correlation between lactate clearance 2 hours (LC2) and lactate clearance 4 hours (LC4) with the success of NOM (p <0.001) with the Odds Ratio (OR) are 3.750 and 6.500 respectively. Based on non-parametric test (Mann Whitney) showed that there were no significant differences between the LC2 and LC4 in determining the successful of NOM (p>0.05).Conclusions: There was a significant relationship between lactate clearance 2 hours (LC2) and lactate clearance 4 hours (LC4) in determining the success of non-operative management (NOM) in patients with history of hemorrhagic shock caused by blunt abdominal trauma. In addition, there are no significant differences between the LC2 and LC4 in determining the success of the NOM, so that either LC2 or LC4 may be used in predicting the success of NOM, as LC4 is the first preference. The low level of lactate clearance may be used as one of indicators to terminate non-operative management and proceed with surgery right before all symptoms of hemorrhagic shock arise.

scholarly journals The Relationship Between Initial Hematocrit and Base Excess For Signs Of Hemorrhagic Shock In Patients With Blunt Abdominal Trauma

2020 ◽  
Vol 45 (1) ◽  
pp. 3-15
Author(s):  
Alfie Barkah Akhsan ◽  
Nurhayat Usman ◽  
Reno Rudiman
Keyword(s):  
Hemorrhagic Shock ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Significant Relationship ◽  
Base Excess ◽  
P Value ◽  
Average Increase ◽  
Satisfactory Outcome ◽  
The Relationship ◽  
Abdominal Hemorrhage

Introduction: Trauma abdominal and pelvic part of the largest causes of death and, if diagnosed early, the deaths could have been prevented. By increasing the capacity for early detection and prompt and appropriate action, will produce a satisfactory outcome. In patients with bleeding, hemodilution appear within a few minutes to obtain a decrease in hematocrit. BE decline is the result of pyruvic acid metabolism occurring anaerobic tissue hypoperfusion due to bleeding unresolved. There is a strong correlation between the decrease in hematocrit and BE with shock because of intra-abdominal haemorrhage. To analyze the relationship between decreased hematocrit and BE in bleeding patients we investigated the relationship between the initial value of hematocrit and BE against any signs of shock because of intra-abdominal hemorrhage in patients with blunt abdominal trauma. Methods: cross-sectional of the 34 subjects. The research data obtained from history taking, physical examination, investigation, and medical records. Conducted a comparative analysis of Kruskal-Wallis. Test for normality by Kolmogorov-Smirnov test. A p value <0.05 indicates a significant relationship between variables. Data were analyzed using SPSS version 19. Result: It was found an average increase in the pulse (P) frequency with decreasing hematocrit (Ht) is 92.67 ± 6.43x / min for group Ht> 40%, 95.5 ± 16.52x / min for group Ht 37-40%, and 112.89 ± 19.23x / min for group Ht <37%. Obtained an average increase of P frequency with decreasing Base Excess (BE) is 88.0 ± 0x / min for groups BE> 2, 92.33 ± 7.84x / min for BE Group 2 - (- 2), and 112.81 ± 19.22x / min for groups BE < -2. This means that there is a significant relationship between hematocrit decrease with increased of P frequency as one of the signs of hemorrhagic shock with p value = 0.046 and significant correlation between the decrease in BE with increased P frequency as one of the signs of hemorrhagic shock with p value = 0.028. Conclusion: There is a significant correlation between the value of the initial hematocrit and BE with signs of hemorrhagic shock due to intra-abdominal hemorrhage in patients with blunt abdominal trauma.

scholarly journals Systematic review of blunt abdominal trauma as a cause of acute appendicitis

2010 ◽  
Vol 92 (6) ◽  
pp. 477-482 ◽  
Author(s):  
Zaher Toumi ◽  
Anthony Chan ◽  
Matthew B Hadfield ◽  
Neil R Hulton
Keyword(s):  
Systematic Review ◽  
Acute Appendicitis ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Quadrant Pain ◽  
Lower Quadrant Pain ◽  
Lower Quadrant ◽  
Right Lower Quadrant Pain ◽  
Presenting Symptoms ◽  
Right Lower Quadrant

INTRODUCTION Acute appendicitis commonly presents as an acute abdomen. Cases of acute appendicitis caused by blunt abdominal trauma are rare. We present a systematic review of appendicitis following blunt abdominal trauma. The aim of this review was to collate and report the clinical presentations and experience of such cases. SUBJECTS AND METHODS A literature review was performed using PubMed, Embase and Medline and the keywords ‘appendicitis’, ‘abdominal’ and ‘trauma’. RESULTS The initial search returned 381 papers, of which 17 articles were included. We found 28 cases of acute appendicitis secondary to blunt abdominal trauma reported in the literature between 1991 and 2009. Mechanisms of injury included road-traffic accidents, falls, assaults and accidents. Presenting symptoms invariably included abdominal pain, but also nausea, vomiting and anorexia. Only 12 patients had computed tomography scans and 10 patients had ultrasonography. All reported treatment was surgical and positive for appendicitis. CONCLUSIONS Although rare, the diagnosis of acute appendicitis must be considered following direct abdominal trauma especially if the patient complains of abdominal right lower quadrant pain, nausea and anorexia. Haemodynamically stable patients who present shortly after blunt abdominal trauma with right lower quadrant pain and tenderness should undergo urgent imaging with a plan to proceed to appendicectomy if the imaging suggested an inflammatory process within the right iliac fossa.

Systematic review and meta-analysis of emergency ultrasonography for blunt abdominal trauma

2001 ◽  
Vol 88 (7) ◽  
pp. 901-912 ◽  
Author(s):  
D. Stengel ◽  
K. Bauwens ◽  
J. Sehouli ◽  
F. Porzsolt ◽  
G. Rademacher ◽  
...  
Keyword(s):  
Systematic Review ◽  
Abdominal Trauma ◽  
Blunt Abdominal Trauma ◽  
Meta Analysis ◽  
Emergency Ultrasonography

The Presence of Hemorrhagic Shock Increases the Rate of Bacterial Translocation in Blunt Abdominal Trauma

1998 ◽  
Vol 44 (1) ◽  
pp. 171-174 ◽  
Author(s):  
Ilhami Taner Kale ◽  
Mehmet Ayhan Kuzu ◽  
Huseyin Berkem ◽  
Rukiye Berkem ◽  
Nilgun Acar
Keyword(s):  
Hemorrhagic Shock ◽  
Abdominal Trauma ◽  
Bacterial Translocation ◽  
Blunt Abdominal Trauma
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