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Inferior vena cava injuries: Are we doing what we really must?
Rodrigo Barros De Carvalho1, Laisa Simakawa Jimenez2, Renato Nardi Pedro2
1Division of Trauma, Department of Surgery, Campinas University Faculty of Medicine, Campinas, Brazil.
Inferior vena cava (IVC) injuries remain highly lethal despite advances in trauma care. Adherence to balanced reanimation and damage control surgery (DCS) is crucial for improving outcomes in patients with IVC trauma.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Surgical Critical Care
Background:
- Inferior vena cava (IVC) injuries are common and associated with high mortality.
- Despite advances in resuscitation, IVC injury mortality has not proportionally improved.
- Predictive factors for IVC injury mortality require further investigation.
Purpose of the Study:
- To identify mortality predictive factors in patients with IVC injuries.
- To evaluate the impact of balanced reanimation and damage control surgery (DCS) on outcomes.
- To compare institutional outcomes with existing literature.
Main Methods:
- Retrospective analysis of trauma patient database records.
- Inclusion of patients with confirmed IVC injuries from January 1990 to August 2017.
- Emphasis on identifying mortality predictors and treatment strategies.
Main Results:
- 74 patients with IVC injury identified; 87.8% penetrating trauma (76.3% gunshot).
- Overall mortality rate was 52.7%; 39.2% for infrarenal injuries.
- Damage control surgery (DCS) was used in 33.8% with 68% mortality.
Conclusions:
- A comprehensive understanding of shock reanimation is essential.
- Trauma care professionals must ensure consistent application of balanced reanimation and DCS.
- Improved application of these strategies may reduce IVC injury mortality.
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