OTA-AAST Pelvic Injury Symposium: Abstracts

Trauma.Org mailing list thread

"Exsanguinating Pelvic Injuries"

Date: Wed, 13 Oct 1999 19:11:32 EDT
Subject: Re: Pelvic External Fixators - waste of time/energy/blood??

We are focusing on the WRONG thesis, the WRONG argument, and are bound to reach the WRONG conclusions. Remember the days of "flail" chest. The patients did not look bad until AFTER they arrived at the hospital and had a lot of fluids. The issue in pelvic fracture is similar. AGGRESSIVE cyclic hyperresuscitation results in a predictable coagulopathy and a rise in venous pressure. This leads to venous bleeding from the pelvic veins, requiring repeat cyclic hyperresuscitation and a viscous cycle requiring still other therapy. The studies of immediate external fixators are virtually ALL WAG data and a lot of "expert opinion" expressed.