Document Detail


Selective Computed Tomography and Angioembolization Provide Benefits in the Management of Patients with Concomitant Unstable Hemodynamics and Negative Sonography Results.
MedLine Citation:
PMID:  22350476     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The FAST (focused assessment of sonography for trauma) examination can rapidly identify free fluid in the abdominal or thoracic cavity, which is indicative of hemorrhage requiring emergency surgery in multiple-trauma patients. In patients with negative FAST examination results, it is difficult to identify the site of the hemorrhage and to plan treatment accordingly. We attempted to delineate the role of selective computed tomography (CT) and transarterial angioembolization (TAE) in the management of such unstable patients. METHODS: From January 2005 to April 2011 patients with concomitant unstable hemodynamics and negative FAST examination results were identified. Their demographic and time to start of embolization were recorded. The initial systolic blood pressure (SBP) in emergency department patients was compared with the SBP after TAE. RESULTS: A total of 33 patients were enrolled, and 85% required TAE. SBP improved significantly after TAE. There were 18 patients who received TAE without CT scan because the site of hemorrhage was obvious. Fifteen patients received a CT scan during the time required for angiography preparation. Ten of them received subsequent TAE based on the CT scan findings, and the treatment plan was changed in the other five patients. There was no significant difference between patients with or without a CT scan with respect to the time interval between arrival and starting embolization. CONCLUSIONS: Transarterial angioembolization is suggested in the management of patients with concomitant unstable hemodynamics and negative FAST examination results. During the time interval required for angiography preparation, a CT scan can be performed. This approach provides valuable information for further decision making without delaying definitive treatment.
Authors:
Chih-Yuan Fu; Chi-Hsun Hsieh; Chun-Han Shih; Yu-Chun Wang; Ray-Jade Chen; Hung-Chang Huang; Jui-Chien Huang; Shih-Chi Wu; Hsun-Chung Tsuo; Hsiu-Jung Tung
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-14
Journal Detail:
Title:  World journal of surgery     Volume:  -     ISSN:  1432-2323     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Trauma and Emergency Surgery, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan, drfu5564@yahoo.com.tw.
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