| Intra-aortic balloon occlusion to salvage patients with life-threatening hemorrhagic shocks from pelvic fractures. | |
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MedLine Citation:
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PMID: 20173661 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to describe a blinded intra-aortic balloon occlusion (IABO) procedure in pelvic fractures (PF) for patients with critically uncontrollable hemorrhagic shock (CUHS). METHODS: Of 2,064 patients treated for PF, 13 underwent IABO during initial resuscitation to control massive pelvic bleeding leading to CUHS. Our IABO procedure consists of internal aortic occlusion without fluoroscopy, using a latex balloon inflated in the infrarenal aorta. Retrospectively collected data included demographics, fracture classification, additional injuries, blood transfusions, surgical interventions, angiographic procedure, physiologic parameters, and survival. RESULTS: All balloons were successfully placed, and a significant increase in systolic blood pressure (70 mm Hg, p = 0.001) was observed immediately after IABO. Twelve of 13 patients became transferrable. Angiography performed after IABO was positive for arterial injury in 92% of patients, and 9 patients benefitted from arterial embolization. Survival rate was 46% (6 of 13) and was inversely related to the length of inflation (p = 0.026) and the mean Injury Severity Score (p = 0.011). CONCLUSION: This IABO procedure can be life saving in the management of patients with CUHS from PF, permitting transport to angiography. However, the decision for such treatment must be as quickly as possible after trauma to reduce the time of occlusion. |
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Authors:
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Thomas Martinelli; Frédéric Thony; Philippe Decléty; Christian Sengel; Christophe Broux; Jérôme Tonetti; Jean-François Payen; Gilbert Ferretti |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of trauma Volume: 68 ISSN: 1529-8809 ISO Abbreviation: J Trauma Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-13 Completed Date: 2010-05-06 Revised Date: 2010-10-18 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: United States |
Other Details:
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Languages: eng Pagination: 942-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Radiology and Medical Imaging, Grenoble University Hospital, Grenoble, France. thomas.martinelli@chru-lille.fr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Angiography Aorta, Abdominal* Balloon Occlusion / methods* Blood Transfusion / statistics & numerical data Female Fractures, Bone / complications* Humans Injury Severity Score Male Pelvic Bones / injuries*, surgery* Retrospective Studies Salvage Therapy* Shock, Hemorrhagic / etiology, therapy* Survival Rate Treatment Outcome |
| Comments/Corrections | |
Comment In:
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J Trauma. 2010 Oct;69(4):1005-6; author reply 1006-7
[PMID:
20938300
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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