Services on Demand
Journal
Article
Indicators
Cited by SciELO
Access statistics
Related links
Cited by Google
Similars in SciELO
Similars in Google
Share
Colombian Journal of Anestesiology
Print version ISSN 0120-3347
Abstract
ARIZA, Fredy et al. Are we meeting current recommendations for the initial management of penetrating trauma? A preliminary analysis from a Colombian institutional registry. Rev. colomb. anestesiol. [online]. 2017, vol.45, n.1, pp.39-45. ISSN 0120-3347.
Abstract Introduction: To achieve minimal physiological goals in patients with penetrating thoracoabdominal trauma (TAPT) is essential to ensure adequate outcomes. Objectives: To determine the success in meting basic standards at the end of damage control surgery in subjects with TAPT: (1) Monitoring and prevention of hyperfibrinolysis; (2) central temperature >35 °C; (3) platelet count >50,000/mm3 and serum fibrinogen >150mg/dl; (4) hemoglobin levels >7.5 mg/dl and base deficit <6. Methods: Subjects >18 years old undergoing damage control surgery as a result of TAPT were prospectively collected at a referral center between October Oct-2012 and Dec-2014. Comparisons were done according to the Injury Severity Score (ISS) with a severity value indicator of >25. A p < 0.05 value was considered significant. Results:106 subjects with TAPT were enrolled. Administration of tranexamic acid was only reported in 52.7% of the patients, particularly in the group with low severity scores [Group ISS < 25 36.3% vs. group ISS > 25 65.8%. OR 3.37 (95% CI 1.2-9.85); p = 0.01]. Although the temperature was reported in 91% of the cases, only 66.2-71.4% reached the recommended goal. Serum fibrinogen was measured in 59.5% of the cases and only 52% met the recommended level. The base deficit values of <6 at the end of surgery were only accomplished in 40-43.8% of the subjects, with a significantly lower probability in the more severe patients [53% vs. 35.9%. OR 2.04 (95% CI 1.2-6.02); p = 0.042]. Conclusions: A considerable proportion of patients with TAPT does not meet the current recommendations at the end of damage control surgery.
Keywords : Mortality; Tranexamic acid; Blood coagulation disorders; Multiple trauma; Abdomen.