American Association for the Surgery of Trauma Organ Injury Scale I: Spleen, Liver, and Kidney, Validation Based on the National Trauma Data Bank

Tinkoff, Glen; Esposito, Thomas J.; Reed, James F.; Kilgo, Patrick D.; Fildes, John; Pasquale, Michael D.; Meredith, J. Wayne

doi:10.1016/j.jamcollsurg.2008.06.342

Cited by 348 publications

(226 citation statements)

References 19 publications

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“…[6] A 2008 study showed that 86.3% of hepatic injuries are now managed without operative intervention. [9] Indications for further intervention by embolization or laparotomy include hemodynamic stability that cannot be achieved after resuscitation, progressive fall of hemoglobin with recurrent blood transfusion, and clinical signs of peritonitis. [3] It is worth noting that the failure of conservative treatment does not necessarily lead to an increase in the incidence of complications or mortality in centers with continued intensive therapy and the immediate possibility of performing surgery.…”

Section: Discussionmentioning

confidence: 99%

Acute liver failure secondary to hepatic compartment syndrome: case report and literature review

Ye¹,

Miao²

2014

Ulus Travma Acil Cerrahi Derg

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We report a case of a patient with a delayed large intrahepatic hematoma and transient decline in hemoglobin to 62 g/L 18 days after liver injury. Abdominal computed tomography revealed seriously flattening of inferior vena cava, which was consistent with compression by the enlarging hematoma. Although traditionally there was no indication for surgical intervention, the patient developed acute liver failure with a progressive increase in liver enzymes and bilirubin. We postulated the ever-expanding hematoma might have led to dramatically elevated intrahepatic pressures that in turn restricted hepatic vein reflux and subsequently resulted in acute liver failure. Therefore, she underwent percutaneous drainage, and the decompression instantly reversed the liver injury. This phenomenon is similar to the well-described abdominal compartment syndrome, which is defined as new onset organ dysfunction or failure secondary to sustained intraabdominal hypertension and in which decompression is the standard treatment.

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Section: Discussionmentioning

confidence: 99%

Acute liver failure secondary to hepatic compartment syndrome: case report and literature review

Ye¹,

Miao²

2014

Ulus Travma Acil Cerrahi Derg

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Section: Discussionmentioning

confidence: 99%

“…37,38 Accordingly, these patients often require substantial transfusions, and high associated mortality correlates with the grade of injury. 37 When operative therapy is required, major liver injuries can also be described as some of the most challenging cases. Because all current massive transfusion literature describes patient morbidity and mortality following generalized injuries, the primary goal of our study was to evaluate the influence of a high plasma ratio MTP on the outcomes of patients with major hepatic trauma.…”

Section: Discussionmentioning

confidence: 99%

The impact of a massive transfusion protocol (1:1:1) on major hepatic injuries: Does it increase abdominal wall closure rates?

et al. 2013

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Background: Massive transfusion protocols (MTPs) using high plasma and platelet ratios for exsanguinating trauma patients are increasingly popular. Major liver injuries often require massive resuscitations and immediate hemorrhage control. Current published literature describes outcomes among patients with mixed patterns of injury. We sought to identify the effects of an MTP on patients with major liver trauma.Methods: Patients with grade 3, 4 or 5 liver injuries who required a massive blood component transfusion were analyzed. We compared patients with high plasma:red blood cell:platelet ratio (1:1:1) transfusions (2007)(2008)(2009)) with patients injured before the creation of an institutional MTP (2005MTP ( -2007.Results: Among 60 patients with major hepatic injuries, 35 (58%) underwent resuscitation after the implementation of an MTP. Patient and injury characteristics were similar between cohorts. Implementation of the MTP significantly improved plasma: red blood cell:platelet ratios and decreased crystalloid fluid resuscitation (p = 0.026). Rapid improvement in early acidosis and coagulopathy was superior with an MTP (p = 0.009). More patients in the MTP group also underwent primary abdominal fascial closure during their hospital stay (p = 0.021). This was most evident with grade 4 injuries (89% vs. 14%). The mean time to fascial closure was 4.2 days. The overall survival rate for all major liver injuries was not affected by an MTP (p = 0.61). Conclusion:The implementation of a formal MTP using high plasma and platelet ratios resulted in a substantial increase in abdominal wall approximation. This occurred concurrently to a decrease in the delivered volume of crystalloid fluid.Contexte : Les protocoles de transfusion massive (PTM) impliquant des rapports plasma:plaquettes élevés sont de plus en plus populaires pour traiter les patients atteints d'un traumatisme hémorragique. Les chirurgies majeures du foie requièrent souvent le déclenchement de protocoles de transfusion massive et une maîtrise immé-diate de l'hémorragie. La littérature actuelle décrit les résultats chez des patients victimes de divers types de traumatismes. Nous avons voulu mesurer les effets d'un PTM sur les patients ayant subi un traumatisme majeur au foie. Résultats : Sur 50 patients ayant subi des lésions hépatiques majeures, 35 (58 %) ont reçu des traitements de réanimation après la mise en place du PTM. Les caractéristiques propres aux patients et à leurs blessures étaient similaires entre les cohortes. L'application du PTM a significativement amélioré les rapports plasma:culots globulaires:plaquettes et réduit l'administration de cristalloïdes à des fins de réanimation liquidienne (p = 0,026). L'amélioration rapide de l'acidose naissante et de la coagulopathie a été meilleure avec le PTM (p = 0,009). Plus de patients du groupe soumis au PTM ont aussi subi une fermeture aponévrotique abdominale primaire durant leur séjour hospitalier (p = 0,021). Cela s'est surtout observé avec les lésions de grade 4 (89 % c. 14 %). Le délai moyen av...

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“…We compared patient characteristics (age, sex, injury mechanism), AIS, ISS, and spleen injury grade. Spleen injury grading follows the American Association for the Surgery of Trauma (AAST) Splenic Injury Scale [6][7][8] (Table 1). …”

Section: Methodsmentioning

confidence: 99%

Treatment Option for High Grade Spleen Injury and Predictive Factors for Non-operative Management

Lee

et al. 2017

Journal of Trauma and Injury

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American Association for the Surgery of Trauma Organ Injury Scale I: Spleen, Liver, and Kidney, Validation Based on the National Trauma Data Bank

Cited by 348 publications

References 19 publications

Acute liver failure secondary to hepatic compartment syndrome: case report and literature review

Acute liver failure secondary to hepatic compartment syndrome: case report and literature review

The impact of a massive transfusion protocol (1:1:1) on major hepatic injuries: Does it increase abdominal wall closure rates?

Treatment Option for High Grade Spleen Injury and Predictive Factors for Non-operative Management

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