Damage-control resuscitation increases successful nonoperative management rates and survival after severe blunt liver injury

The Journal of Trauma and Acute Care Surgery
Binod ShresthaCharles E Wade

Abstract

Nonoperative multidisciplinary management for severe (American Association for the Surgery of Trauma Grades IV and V) liver injury has been used for two decades. We have previously shown that Damage Control Resuscitation (DCR) using low-volume, balanced resuscitation improves survival of severely injured trauma patients; however, little attention has been paid to organ-specific outcomes. We wanted to determine if implementation of DCR has improved survival and successful nonoperative management after severe blunt liver injury. A retrospective study was performed on all adult trauma patients with severe blunt liver injury who were admitted from 2005 to 2011. Patients were divided into pre-DCR (2005-2008) and DCR (2009-2011) groups. Patients who died before leaving the emergency department (ED) were excluded. Outcomes (resuscitation products used, survival, and length of stay) were then compared by univariate and multivariate analyses. Between 2005 and 2011, 29,801 adult trauma patients were admitted, and 1,412 (4.7%) experienced blunt liver injury. Of these, 244 (17%) sustained Grade IV and V injuries, with 206 patients surviving to leave the ED. The pre-DCR group (2005-2008) was composed of 108 patients, and the DCR group (2009...Continue Reading

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Citations

Jan 13, 2016·American Journal of Surgery·John A HarvinJohn B Holcomb
Feb 3, 2016·Current Opinion in Anaesthesiology·Christopher T StephensJohn B Holcomb
Jul 12, 2016·The American Journal of Emergency Medicine·Claire RogerJean-Yves Lefrant
Oct 26, 2016·Transplantation·Marek KrawczykUNKNOWN European Liver and Intestine Transplant Association (ELITA)
Nov 30, 2018·PloS One·Ujwal R YanalaMark A Carlson
Jun 4, 2019·AACN Advanced Critical Care·Heather M Passerini
Oct 17, 2017·Current Opinion in Critical Care·Daniel Benz, Zsolt J Balogh
Oct 11, 2017·Current Opinion in Critical Care·Christine GaarderPål A Næss
Feb 6, 2020·Minerva chirurgica·Bianca MitricofFlorin Botea
Jan 6, 2019·World Journal of Surgery·Noha FerrahBen Beck
Nov 18, 2018·Transfusion·Qiyong Peter LiuMary-Anne Fell
Jul 28, 2019·The Journal of Trauma and Acute Care Surgery·Kamil HannaBellal Joseph
Jun 3, 2017·Scientific Reports·Kumar SubramaniRaghavan Raju
Nov 13, 2020·Trauma Surgery & Acute Care Open·Adam BrooksChristine Gaarder
Aug 19, 2020·The Journal of Surgical Research·Monica L WagnerMichael D Goodman
Apr 20, 2021·Indian Journal of Hematology & Blood Transfusion : an Official Journal of Indian Society of Hematology and Blood Transfusion·Liu WeiLe Aiping
Jul 17, 2021·Khirurgiia·A N AnipchenkoA V Fedorov

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