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Hemodynamically unstable pelvic fracture: A damage control surgical algorithm that fits your reality / David Alejandro Mejía Toro ; Salín Pereira Warr    

Público ISBD Título : Hemodynamically unstable pelvic fracture: A damage control surgical algorithm that fits your reality Otros títulos : Trauma pélvico e inestabilidad hemodinámica: Un algoritmo quirúrgico de control de daños que se adapta con su realidad Tipo de documento : documento electrónico Autores : David Alejandro Mejía Toro, ; Salín Pereira Warr, Fecha de publicación : 2020 Títulos uniformes : Colombia Médica Idioma : Inglés (eng) Palabras clave : Hemodynamically Unstable  Damage Control  Pelvic Fracture  REBOA  Limited Resource Center Resumen : Pelvic fractures occur in up to 25% of all severely injured trauma patients and its mortality is markedly high despite advances in resuscitation and modernization of surgical techniques due to its inherent blood loss and associated extra-pelvic injuries. Pelvic ring volume increases significantly from fractures and/or ligament disruptions which precludes its inherent ability to self-tamponade resulting in accumulation of hemorrhage in the retroperitoneal space which inevitably leads to hemodynamic instability and the lethal diamond. Pelvic hemorrhage is mainly venous (80%) from the pre-sacral/pre-peritoneal plexus and the remaining 20% is of arterial origin (branches of the internal iliac artery). This reality can be altered via a sequential management approach that is tailored to the specific reality of the treating facility which involves a collaborative effort between orthopedic, trauma and intensive care surgeons. We propose two different management algorithms that specifically address the availability of qualified staff and existing infrastructure: one for the fully equipped trauma center and another for the very common limited resource center. Mención de responsabilidad : David Mejia, Michael W. Parra, Carlos A. Ordoñez, Natalia Padilla, Yaset Caicedo, Salin Pereira Warr, Paula Andrea Jurado-Muñoz, Mauricio Torres, Alfredo Martínez, José Julián Serna, Fernando Rodríguez-Holguín, Alexander Salcedo, Alberto García, Mauricio Millán, Luis Fernando Pino, Adolfo González Hadad, Mario Alain Herrera, Ernest E. Moore Referencia : Colomb Med (Cali). 2020 Dec 30;51(4):e4214510. DOI (Digital Object Identifier) : 10.25100/cm.v51i4.4510 PMID : 33795905 Derechos de uso : CC BY-NC En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4510 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5739 Hemodynamically unstable pelvic fracture: A damage control surgical algorithm that fits your reality = Trauma pélvico e inestabilidad hemodinámica: Un algoritmo quirúrgico de control de daños que se adapta con su realidad [documento electrónico] / David Alejandro Mejía Toro, ; Salín Pereira Warr,  . - 2020. Obra : Colombia Médica Idioma : Inglés (eng) Palabras clave : Hemodynamically Unstable  Damage Control  Pelvic Fracture  REBOA  Limited Resource Center Resumen : Pelvic fractures occur in up to 25% of all severely injured trauma patients and its mortality is markedly high despite advances in resuscitation and modernization of surgical techniques due to its inherent blood loss and associated extra-pelvic injuries. Pelvic ring volume increases significantly from fractures and/or ligament disruptions which precludes its inherent ability to self-tamponade resulting in accumulation of hemorrhage in the retroperitoneal space which inevitably leads to hemodynamic instability and the lethal diamond. Pelvic hemorrhage is mainly venous (80%) from the pre-sacral/pre-peritoneal plexus and the remaining 20% is of arterial origin (branches of the internal iliac artery). This reality can be altered via a sequential management approach that is tailored to the specific reality of the treating facility which involves a collaborative effort between orthopedic, trauma and intensive care surgeons. We propose two different management algorithms that specifically address the availability of qualified staff and existing infrastructure: one for the fully equipped trauma center and another for the very common limited resource center. Mención de responsabilidad : David Mejia, Michael W. Parra, Carlos A. Ordoñez, Natalia Padilla, Yaset Caicedo, Salin Pereira Warr, Paula Andrea Jurado-Muñoz, Mauricio Torres, Alfredo Martínez, José Julián Serna, Fernando Rodríguez-Holguín, Alexander Salcedo, Alberto García, Mauricio Millán, Luis Fernando Pino, Adolfo González Hadad, Mario Alain Herrera, Ernest E. Moore Referencia : Colomb Med (Cali). 2020 Dec 30;51(4):e4214510. DOI (Digital Object Identifier) : 10.25100/cm.v51i4.4510 PMID : 33795905 Derechos de uso : CC BY-NC En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4510 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5739

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Código de barras	Número de Ubicación	Tipo de medio	Ubicación	Sección	Estado
DD001691	AC-2020-149	Archivo digital	Producción Científica	Artículos científicos	Disponible

Documentos electrónicos

2020-149 Adobe Acrobat PDF

REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients / David Alejandro Mejía Toro    

Público ISBD Título : REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients Otros títulos : El REBOA como nuevo actor en el control de daños del paciente hemodinámicamente inestable con hemorragia no compresible del torso Tipo de documento : documento electrónico Autores : David Alejandro Mejía Toro, Fecha de publicación : 2020 Títulos uniformes : Colombia Médica Idioma : Inglés (eng) Palabras clave : Resuscitative Endovascular Balloon Occlusion of the Aorta  Damage Control  Non-Compressible Torso Hemorrhage  Hemodynamically Unstable  Wounds  Gunshot  Injury Severity Score  Trauma Centers  Advanced Trauma Life Support Care  Balloon Occlusion  Nonpenetrating  Endovascular Procedures  REBOA Resumen : Noncompressible torso hemorrhage is one of the leading causes of preventable death worldwide. An efficient and appropriate evaluation of the trauma patient with ongoing hemorrhage is essential to avoid the development of the lethal diamond (hypothermia, coagulopathy, hypocalcemia, and acidosis). Currently, the initial management strategies include permissive hypotension, hemostatic resuscitation, and damage control surgery. However, recent advances in technology have opened the doors to a wide variety of endovascular techniques that achieve these goals with minimal morbidity and limited access. An example of such advances has been the introduction of the Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), which has received great interest among trauma surgeons around the world due to its potential and versatility in areas such as trauma, gynecology & obstetrics and gastroenterology. This article aims to describe the experience earned in the use of REBOA in noncompressible torso hemorrhage patients. Our results show that REBOA can be used as a new component in the damage control resuscitation of the severely injured trauma patient. To this end, we propose two new deployment algorithms for hemodynamically unstable noncompressible torso hemorrhage patients: one for blunt and another for penetrating trauma. We acknowledge that REBOA has its limitations, which include a steep learning curve, its inherent cost and availability. Although to reach the best outcomes with this new technology, it must be used in the right way, by the right surgeon with the right training and to the right patient. Mención de responsabilidad : Carlos A. Ordoñez, Michael W. Parra, Yaset Caicedo, Natalia Padilla, Fernando Rodríguez-Holguín, José Julián Serna, Alexander Salcedo, Alberto García, Claudia Orlas, Luis Fernando Pino, Ana Milena del Valle, David Mejia, Juan Carlos Salamea-Molina, Megan Brenner, Tal Hörer Referencia : Colomb Med (Cali). 2020 Dec 30;51(4):e4064506 DOI (Digital Object Identifier) : 10.25100/cm.v51i4.4506 PMID : 33795901 Derechos de uso : CC BY-NC-ND En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4506/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5733 REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients = El REBOA como nuevo actor en el control de daños del paciente hemodinámicamente inestable con hemorragia no compresible del torso [documento electrónico] / David Alejandro Mejía Toro,  . - 2020. Obra : Colombia Médica Idioma : Inglés (eng) Palabras clave : Resuscitative Endovascular Balloon Occlusion of the Aorta  Damage Control  Non-Compressible Torso Hemorrhage  Hemodynamically Unstable  Wounds  Gunshot  Injury Severity Score  Trauma Centers  Advanced Trauma Life Support Care  Balloon Occlusion  Nonpenetrating  Endovascular Procedures  REBOA Resumen : Noncompressible torso hemorrhage is one of the leading causes of preventable death worldwide. An efficient and appropriate evaluation of the trauma patient with ongoing hemorrhage is essential to avoid the development of the lethal diamond (hypothermia, coagulopathy, hypocalcemia, and acidosis). Currently, the initial management strategies include permissive hypotension, hemostatic resuscitation, and damage control surgery. However, recent advances in technology have opened the doors to a wide variety of endovascular techniques that achieve these goals with minimal morbidity and limited access. An example of such advances has been the introduction of the Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), which has received great interest among trauma surgeons around the world due to its potential and versatility in areas such as trauma, gynecology & obstetrics and gastroenterology. This article aims to describe the experience earned in the use of REBOA in noncompressible torso hemorrhage patients. Our results show that REBOA can be used as a new component in the damage control resuscitation of the severely injured trauma patient. To this end, we propose two new deployment algorithms for hemodynamically unstable noncompressible torso hemorrhage patients: one for blunt and another for penetrating trauma. We acknowledge that REBOA has its limitations, which include a steep learning curve, its inherent cost and availability. Although to reach the best outcomes with this new technology, it must be used in the right way, by the right surgeon with the right training and to the right patient. Mención de responsabilidad : Carlos A. Ordoñez, Michael W. Parra, Yaset Caicedo, Natalia Padilla, Fernando Rodríguez-Holguín, José Julián Serna, Alexander Salcedo, Alberto García, Claudia Orlas, Luis Fernando Pino, Ana Milena del Valle, David Mejia, Juan Carlos Salamea-Molina, Megan Brenner, Tal Hörer Referencia : Colomb Med (Cali). 2020 Dec 30;51(4):e4064506 DOI (Digital Object Identifier) : 10.25100/cm.v51i4.4506 PMID : 33795901 Derechos de uso : CC BY-NC-ND En línea : https://colombiamedica.univalle.edu.co/index.php/comedica/article/view/4506/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5733

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Código de barras	Número de Ubicación	Tipo de medio	Ubicación	Sección	Estado
DD001672	AC-2020-143	Archivo digital	Producción Científica	Artículos científicos	Disponible

Documentos electrónicos

2020-143 Adobe Acrobat PDF