[The initial management in intensive care of pelvic ring injury patients].
Pelvic trauma care is complex since it is frequently associated with multiple injuries and may lead to dramatic and uncontrollable haemorrhage. After pelvic trauma, the mortality, around 8 to 10%, is mainly related to severe pelvic hemorrhage but also to extrapelvic injuries (thoracic, abdominal or brain injuries). It is therefore crucial to manage pelvic trauma in specialized trauma center. The initial trauma assessment aims to determine the role of the pelvic injury in hemorrhage to define the therapeutic strategy of pelvic trauma care (arterial embolisation/pelvic ring stabilisation). This review was performed with a systematic review of the literature; it describes the pelvic fracture pathophysiology, and the efficacy and safety of haemostatic procedures and with their respective indications. A decision making algorithm is proposed for the treatment of trauma patients with pelvic fracture.
Pôle anesthésie-réanimation, équipe d'accueil « Modélisation de l'agression tissulaire et nociceptive », université Toulouse 3 Paul-Sabatier, centre hospitalier universitaire de Toulouse, place du Dr-Baylac, 31059 Toulouse cedex 09, France.
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Vardon
Département d'anesthésie-réanimation chirurgicale, centre hospitalier universitaire de Bicêtre, hôpitaux universitaire Paris-Sud, 78, avenue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France.
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Harrois
Département d'anesthésie-réanimation chirurgicale, centre hospitalier universitaire de Bicêtre, hôpitaux universitaire Paris-Sud, 78, avenue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France.
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Duranteau
Pôle anesthésie-réanimation, équipe d'accueil « Modélisation de l'agression tissulaire et nociceptive », université Toulouse 3 Paul-Sabatier, centre hospitalier universitaire de Toulouse, place du Dr-Baylac, 31059 Toulouse cedex 09, France. Electronic address: geeraerts.t@chu-toulouse.fr.
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Geeraerts
D003422:Critical Care / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D009104:Multiple Trauma / Q000628:therapy; D010388:Pelvis / Q000293:injuries*; D014193:Trauma Centers
Arterial embolization; Choc hémorragique; Embolisation artérielle; External pelvic fixation; Fixation pelvienne; Haemorragic shock; Hématome rétropéritonéal; Pelvic trauma; Retroperitoneal hematoma; Traumatisme du bassin