[Pelvic Ring Fractures - in extremis Patients].

Area of Science:

• Trauma Surgery
• Hemorrhagic Shock Management
• Pelvic Fracture Treatment

Context:

• Severe pelvic ring fractures often lead to life-threatening hemorrhagic shock.
• Existing treatment algorithms are inadequate for patients with extreme hemodynamic instability.
• A 10-year retrospective analysis of prospectively collected trauma data was conducted.

Purpose:

• To analyze a subpopulation of patients with severe hemorrhagic shock and concurrent unstable pelvic ring fractures.
• To develop and evaluate a novel hemostatic algorithm for these critical patients.
• To identify key interventions for improving survival rates.

Summary:

• The study identified 22 patients 'in extremis' with systolic pressure <70 mm Hg and/or hemoglobin <80 g/l.
• A new algorithm involving pelvic stabilization, extraperitoneal packing, and vasography was implemented.
• This algorithm proved effective in managing bleeding and improving patient outcomes.

Impact:

• The developed hemostatic algorithm significantly improved the management of hemodynamically unstable patients with pelvic ring injuries.
• Early implementation of pelvic stabilization and packing is crucial.
• The algorithm provides a standardized approach, reducing mortality associated with inadequate hemostasis.