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Paper Information

Journal:   BULLETIN OF EMERGENCY AND TRAUMA BEAT   2014 , Volume 2 , Number 3; Page(s) 125 To 129.
 
Paper: 

DETERMINANTS OF SUCCESSFUL NON-OPERATIVE MANAGEMENT OF INTRA-PERITONEAL BLEEDING FOLLOWING BLUNT ABDOMINAL TRAUMA

 
 
Author(s):  HEIDAR AMMAR, RAVANFAR PARSA*, NAMAZI GOLNAZ, NIKSERESHT TAHA, NIAKAN HADI
 
* TRAUMA RESEARCH CENTER, DEPARTMENT OF SURGERY, SHAHID RAJAEE (EMTIAZ) TRAUMA HOSPITAL, SHIRAZ UNIVERSITY OF MEDICAL SCIENCES, SHIRAZ, IRAN
 
Abstract: 

Objectives: To identify the predictive factors of successful non-operative management of patients with intraperitoneal bleeding following blunt abdominal trauma.
Methods: This was cross-sectional study being performed in our Level I trauma center in southern Iran between 2010 and 2011. We included adult (>14 years) patients with blunt abdominal trauma and intraperitoneal hemorrhage detected by CT-Scan who were hemodynamically stable and did not require any surgical intervention. Patients were managed conservatively in ICU. Those who required laparotomy during the study period were named as non-operative management failure (NOM-F) while the other were nonoperative management success (NOM-S). The baseline, clinical and laboratory characteristics were compared between two study groups in order to detect the predictors of successful NOM of intra-peritoneal bleeding.
Results: Overall we included 80 eligible patients among whom there were 55 (68.7%) men and 25 (31.3%) women with mean age of 30.63.6±years. Finally, 43 (53.8%) were successfully managed conservatively (NOM-S) while 37 (46.2%) required laparotomy (NOM-F). We found that those who underwent emergency laparotomy had significantly higher ?Hb (p=0.016) and lower base deficit (p=0.005) when compared to those who were successfully managed conservatively. Those who required surgical intervention had significantly lower baseline systolic blood pressure (p<0.001) and higher shock index (p=0.002). The other parameters such as pulse rate and respiratory rate were comparable between two study groups.
Conclusion: In patients with intra-peritoneal bleeding following blunt abdominal trauma, the most reliable predictive clinical and para-clinical factor of successful non-operative management are shock index and systolic blood pressure on arrival, base deficit and hemoglobin drop within first 12 hours of admission.

 
Keyword(s): BLUNT ABDOMINAL TRAUMA, INTRA-PERITONEAL BLEEDING, NON-OPERATIVE MANAGEMENT, CONSERVATIVE THERAPY
 
 
References: 
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Click to Cite.
APA: Copy

HEIDAR, A., & RAVANFAR, P., & NAMAZI, G., & NIKSERESHT, T., & NIAKAN, H. (2014). DETERMINANTS OF SUCCESSFUL NON-OPERATIVE MANAGEMENT OF INTRA-PERITONEAL BLEEDING FOLLOWING BLUNT ABDOMINAL TRAUMA. BULLETIN OF EMERGENCY AND TRAUMA BEAT, 2(3), 125-129. https://www.sid.ir/en/journal/ViewPaper.aspx?id=403276



Vancouver: Copy

HEIDAR AMMAR, RAVANFAR PARSA, NAMAZI GOLNAZ, NIKSERESHT TAHA, NIAKAN HADI. DETERMINANTS OF SUCCESSFUL NON-OPERATIVE MANAGEMENT OF INTRA-PERITONEAL BLEEDING FOLLOWING BLUNT ABDOMINAL TRAUMA. BULLETIN OF EMERGENCY AND TRAUMA BEAT. 2014 [cited 2021May11];2(3):125-129. Available from: https://www.sid.ir/en/journal/ViewPaper.aspx?id=403276



IEEE: Copy

HEIDAR, A., RAVANFAR, P., NAMAZI, G., NIKSERESHT, T., NIAKAN, H., 2014. DETERMINANTS OF SUCCESSFUL NON-OPERATIVE MANAGEMENT OF INTRA-PERITONEAL BLEEDING FOLLOWING BLUNT ABDOMINAL TRAUMA. BULLETIN OF EMERGENCY AND TRAUMA BEAT, [online] 2(3), pp.125-129. Available: https://www.sid.ir/en/journal/ViewPaper.aspx?id=403276.



 
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