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Abdominal packing for severe hemorrhage

S Stylianos1

  • 1Division of Pediatric Surgery, Babies & Children's Hospital of New York, New York 10032, USA.

Journal of Pediatric Surgery
|March 14, 1998
PubMed
Summary

Temporary abdominal packing (PACKS) effectively controlled refractory hemorrhage in pediatric patients, improving survival rates. This life-saving technique provides critical time to manage coagulopathy, hypothermia, and acidosis in critically ill children.

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Area of Science:

  • Pediatric Surgery
  • Trauma Surgery
  • Critical Care Medicine

Background:

  • Diffuse abdominal or retroperitoneal hemorrhage poses a significant lethal risk, especially when compounded by coagulopathy, hypothermia, and acidosis.
  • Temporary abdominal packing (PACKS) is a temporizing measure to control bleeding and allow for correction of critical physiological derangements.

Purpose of the Study:

  • To evaluate the efficacy of temporary abdominal packing (PACKS) in pediatric patients with refractory abdominal or retroperitoneal hemorrhage.
  • To assess the outcomes and survival rates associated with PACKS in a multi-institutional pediatric cohort.

Main Methods:

  • A retrospective review of pediatric patients treated with PACKS across 13 institutions was conducted.
  • Data collected included patient demographics, etiology and site of hemorrhage, physiological status, operative details, and outcomes.

Main Results:

  • Twenty-two pediatric patients (6 days to 20 years) with refractory hemorrhage underwent PACKS.
  • PACKS controlled hemorrhage in 95% of patients, with 82% surviving the procedure.
  • Common indications included trauma (13 patients) and solid organ tumor bed bleeding (4 patients); 91% of patients presented with coagulopathy, hypothermia, and acidosis.

Conclusions:

  • Temporary abdominal packing (PACKS) is a life-saving intervention for pediatric patients experiencing refractory abdominal or retroperitoneal hemorrhage.
  • The technique is effective in controlling bleeding and improving survival in critically ill children with associated physiological derangements.

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