The Blunt Liver and Spleen Trauma (BLAST) audit: national survey and prospective audit of children with blunt liver and spleen trauma in major trauma centres

被引：4

作者：

Harwood, R. ^{[1
]}

Bethell, G. ^{[1
]}

Eastwood, M. P. ^{[1
]}

Hotonu, S. ^{[1
]}

Allin, B. ^{[1
]}

Boam, T. ^{[1
]}

Rees, C. M. ^{[1
]}

Hall, N. J. ^{[1
]}

Rhodes, H. ^{[1
]}

Ampirska, T. ^{[1
]}

Arthur, F. ^{[1
]}

Billington, J. ^{[1
]}

Bough, G. ^{[1
]}

Burdall, O. ^{[1
]}

Burnand, K. ^{[1
]}

Chhabra, S. ^{[1
]}

Driver, C. ^{[1
]}

Ducey, J. ^{[1
]}

Engall, N. ^{[1
]}

Folaranmi, E. ^{[1
]}

Gracie, D. ^{[1
]}

Ford, K. ^{[1
]}

Fox, C. ^{[1
]}

Green, P. ^{[1
]}

Green, S. ^{[1
]}

Jawaid, W. ^{[1
]}

John, M. ^{[1
]}

Koh, C. ^{[1
]}

Lam, C. ^{[1
]}

Lewis, S. ^{[1
]}

Lindley, R. ^{[1
]}

Macafee, D. ^{[1
]}

Marks, I. ^{[1
]}

Thompson, H. ^{[1
]}

Tullie, L. ^{[1
]}

Vecchione, S. ^{[1
]}

Tyraskis, A. ^{[1
]}

Maldonado, B. Nezafat ^{[1
]}

Pissaridou, M. ^{[1
]}

Sanchez-Thompson, N. ^{[1
]}

Morris, L. ^{[1
]}

John, M. ^{[1
]}

Godse, A. ^{[1
]}

Farrelly, P. ^{[1
]}

Cullis, P. ^{[1
]}

McHoney, M. ^{[1
]}

Colvin, D. ^{[1
]}

机构：

[1] Collaborat Natl Res Grp, Alder Hey Pk,East Prescot Rd, Liverpool, Merseyside, England

来源：

EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY | 2023年 / 49卷 / 05期

关键词：

Trauma; Pediatric; Blunt injury; Liver Spleen; SPLENIC TRAUMA; FOLLOW-UP; INJURY; MANAGEMENT; PSEUDOANEURYSMS; ENGLAND; HISTORY; WALES;

D O I：

10.1007/s00068-022-01990-3

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Purpose To compare the reported and observed management of UK children with blunt liver or spleen injury (BLSI) to the American Pediatric Surgical Association (APSA) 2019 BLSI guidance. Methods UK Paediatric Major Trauma Centres (pMTCs) undertook 1 year of prospective data collection on children admitted to or discussed with those centres with BLSI and an online questionnaire was distributed to all consultants who care for children with BLSI in those centres. Results All 21/21 (100%) pMTCs participated; 131 patients were included and 100/152 (65%) consultants responded to the survey. ICU care was reported and observed to be primarily determined using haemodynamic status or concomitant injuries rather than injury grade, in accordance with APSA guidance. Bed rest was reported to be determined by grade of injury by 63% of survey respondents and observed in a similar proportion of patients. Contrary to APSA guidance, follow-up radiological assessment of the injured spleen or liver was undertaken in 44% of patients before discharge and 32% after discharge, the majority of whom were asymptomatic. Conclusions UK management of BLSI differs from many aspects of APSA guidance. A shift towards using clinical features to determine ICU admission and readiness for discharge is demonstrated, in line with a strong evidence base. However, routine bed rest and re-imaging after BLSI is common, contrary to APSA guidance. This disparity may exist due to concern that evidence around the incidence, presentation and natural history of complications after conservatively managed BLSI, particularly bleeding from pseudoaneurysms, is weak.

引用

页码：2249 / 2256

页数：8

共 31 条

[1]

[Anonymous], 2012, RCPCH EVIDENCE STATE

[2]

APSA, 2019, UPDATED APSA BLUNT L

[3] A core outcome set for damage control laparotomy via modified Delphi method [J].

Byerly, Saskya ;

Nahmias, Jeffry ;

Stein, Deborah M. ;

Haut, Elliott R. ;

Smith, Jason W. ;

Gelbard, Rondi ;

Ziesmann, Markus ;

Boltz, Melissa ;

Zarzaur, Ben L. ;

Bala, Miklosh ;

Bernard, Andrew ;

Brakenridge, Scott ;

Brohi, Karim ;

Collier, Bryan ;

Burlew, Clay Cothren ;

Cripps, Michael ;

Crookes, Bruce ;

Diaz, Jose J. ;

Duchesne, Juan ;

Harvin, John A. ;

Inaba, Kenji ;

Ivatury, Rao ;

Kasten, Kevin ;

Kerby, Jeffrey D. ;

Lauerman, Margaret ;

Loftus, Tyler ;

Miller, Preston R. ;

Scalea, Thomas ;

Yeh, D. Dante .

TRAUMA SURGERY & ACUTE CARE OPEN, 2022, 7 (01)

[4] The Advanced Trauma Life Support course: a history of its development and review of related literature [J].

Carmont, MR .

POSTGRADUATE MEDICAL JOURNAL, 2005, 81 (952) :87-91

[5] Adherence to Guidelines in Adult Patients with Traumatic Brain Injury: A Living Systematic Review [J].

Cnossen, Maryse C. ;

Scholten, Annemieke C. ;

Lingsma, Hester F. ;

Synnot, Anneliese ;

Tavender, Emma ;

Gantner, Dashiell ;

Lecky, Fiona ;

Steyerberg, Ewout W. ;

Polinder, Suzanne .

JOURNAL OF NEUROTRAUMA, 2021, 38 (08) :1072-1085

[6] What's the Incidence of Delayed Splenic Bleeding in Children After Blunt Trauma? An Institutional Experience and Review of the Literature [J].

Davies, Dafydd A. ;

Fecteau, Annie ;

Himidan, Sharifa ;

Mikrogianakis, Angelo ;

Wales, Paul W. .

JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2009, 67 (03) :573-577

[7] National trends in pediatric blunt spleen and liver injury management and potential benefits of an abbreviated bed rest protocol [J].

Dodgion, Christopher M. ;

Gosain, Ankush ;

Rogers, Andrew ;

St Peter, Shawn D. ;

Nichol, Peter F. ;

Ostlie, Daniel J. .

JOURNAL OF PEDIATRIC SURGERY, 2014, 49 (06) :1004-1008

[8] Post-traumatic liver and splenic pseudoaneurysms in children: Diagnosis, management, and follow-up screening using contrast enhanced ultrasound (CEUS) [J].

Durkin, Natalie ;

Deganello, Annamaria ;

Sellars, Maria E. ;

Sidhu, Paul S. ;

Davenport, Mark ;

Makin, Erica .

JOURNAL OF PEDIATRIC SURGERY, 2016, 51 (02) :289-292

[9] Improving the quality of web surveys: The checklist for reporting results of Internet e-surveys (CHERRIES) [J].

Eysenbach, G .

JOURNAL OF MEDICAL INTERNET RESEARCH, 2004, 6 (03) :12-16

[10] Non-operative management of solid organ injuries in children: An American Pediatric Surgical Association Outcomes and Evidence Based Practice Committee systematic review [J].

Gates, Robert L. ;

Price, Mitchell ;

Cameron, Danielle B. ;

Somme, Stig ;

Ricca, Robert ;

Oyetunji, Tolulope A. ;

Guner, Yigit S. ;

Gosain, Ankush ;

Baird, Robert ;

Lal, Dave R. ;

Jancelewicz, Tim ;

Shelton, Julia ;

Diefenbach, Karen A. ;

Grabowski, Julia ;

Kawaguchi, Akemi ;

Dasgupta, Roshni ;

Downard, Cynthia ;

Goldin, Adam ;

Petty, John K. ;

Stylianos, Steven ;

Williams, Regan .

JOURNAL OF PEDIATRIC SURGERY, 2019, 54 (08) :1519-1526

← 1 2 3 4 →