Strategies to control massive abdominal bleeding.
Abdominal trauma is divided into blunt and penetrating causes. Massive intraabdominal hemorrhage after injury represents the most dangerous precipitating factor that can affect survival if not promptly managed. The first target to achieve management of bleeding patients is control of the source, and then adequate resuscitation and optimization of hemostasis. New procoagulant drugs as recombinant activated factor VII (rFVIIa) seem to play an interesting role in bleeding control after trauma. Our experience with rFVIIa in six patients who were refractory to standard treatments demonstrated a good survival rate after massive abdominal bleeding. Regardless of new drugs and new technologies, a multidisciplinary approach is the cornerstone of the primary care of the these patients.
Busani
S
S
Cattedra e Servizio di Anestesia e Rianimazione 1, Università di Modena e Reggio Emilia, Policlinico di Modena, Modena, Italy. stefanobusani@tin.it
Cavazzuti
I
I
Marietta
M
M
Pasetto
A
A
Girardis
M
M
D000005:Abdomen / Q000098:blood supply*; D000007:Abdominal Injuries / Q000150:complications*; D001777:Blood Coagulation / Q000187:drug effects; D015942:Factor VIIa / Q000627:therapeutic use*; D006470:Hemorrhage / Q000517:prevention & control*; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D011994:Recombinant Proteins / Q000627:therapeutic use; D017741:Survivors
D006490:Hemostatics; D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa