Factores asociados a falla en el manejo no operatorio de lesiones hepáticas o esplénicas secundarias a trauma abdominal cerrado en niños

Adriana Echavarria Medina, Carlos Hernando Morales Uribe, R. Luis Guillermo Echavarria, Viviana María Vélez Marín, Jorge Alberto Martínez Montoya, David Fernando Aguillón

    Resultado de la investigación: Contribución a una revistaArtículorevisión exhaustiva

    2 Citas (Scopus)

    Resumen

    Introduction: The non operative management (NOM) is the standard management of splenic and liver blunt trauma in pediatric patients.Hemodynamic instability and massive transfusions have been identified as management failures. Few studies evaluate whether there exist factors allowing anticipation of these events. The objective was to identify factors associated with the failure of NOM in splenic and liver injuries for blunt abdominal trauma. Patients and Method: Retrospective analysis between 2007-2015 of patients admitted to the pediatric surgery at University Hospital Saint Vincent Foundation with liver trauma and/or closed Spleen. Results: 70 patients were admitted with blunt abdominal trauma, 3 were excluded for immediate surgery (2 hemodynamic instability, 1 peritoneal irritation). Of 67 patients who received NOM, 58 were successful and 9 showed failure (8 hemodynamic instability, 1 hollow viscera injury). We found 3 factors associated with failure NOM: blood pressure (BP) < 90 mmHg at admission (p = 0.0126; RR = 5.19), drop in hemoglobin (Hb) > 2 g/dl in the first 24 hours (p = 0.0009; RR = 15.3), and transfusion of 3 or more units of red blood cells (RBC) (0.00001; RR = 17.1). Mechanism and severity of trauma and Pediatric Trauma Index were not associated with failure NOM. Conclusions: Children with blunted hepatic or splenic trauma respond to NOM. Factors such as BP < 90 mmHg at admission, an Hb fall > 2 g/dl in the first 24 hours and transfusion of 3 or more units of RBC were associated with the failure in NOM.

    Título traducido de la contribuciónAssociated factors to non-operative management failure of hepatic and splenic lesions secondary to blunt abdominal trauma in children
    Idioma originalEspañol
    Páginas (desde-hasta)470-477
    Número de páginas8
    PublicaciónRevista Chilena de Pediatria
    Volumen88
    N.º4
    DOI
    EstadoPublicada - 1 jul. 2017

    Nota bibliográfica

    Publisher Copyright:
    © 2017, Sociedad Chilena de Pediatria. All rights reserved.

    Palabras clave

    • Blunt abdominal trauma
    • Hepatic trauma
    • Management
    • Non operative
    • Splenic trauma

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