Doing less is better : challenges in complex polytrauma management - case report
Damage control resuscitation, characterized by hemostatic resuscitation with blood products, rapid arrest of bleeding and when possible, permissive hypotension with restricted fluid load form a structured approach in managing a polytrauma patient. When complicated with traumatic rhabdomyolysis how...
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| Format: | Article |
| Language: | en |
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Pusat Perubatan Universiti Kebangsaan Malaysia
2018
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| Online Access: | http://journalarticle.ukm.my/20219/1/26_ms0199_pdf_15364.pdf http://journalarticle.ukm.my/20219/ https://www.medicineandhealthukm.com/toc/13/1 |
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| _version_ | 1834433901101056000 |
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| author | Farah NA, Johar MJ, Ismail Mohd Saiboon, |
| author_facet | Farah NA, Johar MJ, Ismail Mohd Saiboon, |
| author_sort | Farah NA, |
| building | Tun Sri Lanang Library |
| collection | Institutional Repository |
| content_provider | Universiti Kebangsaan Malaysia |
| content_source | UKM Journal Article Repository |
| continent | Asia |
| country | Malaysia |
| description | Damage control resuscitation, characterized by hemostatic resuscitation with blood
products, rapid arrest of bleeding and when possible, permissive hypotension with restricted fluid load form a structured approach in managing a polytrauma
patient. When complicated with traumatic rhabdomyolysis however, permissive
hypotension strategy may cause more harm resulting in subsequent ischaemicreperfusion
injury and acute kidney injury. We present a case involving a 20-yearold
man who was rolled over by a lorry and sustained an open unstable pelvic
fracture with vascular injury and left lower limb ischaemia. Permissive hypotension
strategy was pursued for 4 hours prior to bleeding control in OT. This was
followed by protracted surgery of 6 hours. Coagulopathy, acute kidney injury and
rhabdomyolysis ensued in the post-operative period and patient succumbed to
his injury on Day 3 post-trauma. Challenges and pitfalls in managing a complex
polytrauma patient and recent evidences on damage control resuscitation is
discussed. |
| format | Article |
| id | my-ukm.journal.20219 |
| institution | Universiti Kebangsaan Malaysia |
| language | en |
| publishDate | 2018 |
| publisher | Pusat Perubatan Universiti Kebangsaan Malaysia |
| record_format | eprints |
| spelling | my-ukm.journal.202192022-10-21T08:45:31Z http://journalarticle.ukm.my/20219/ Doing less is better : challenges in complex polytrauma management - case report Farah NA, Johar MJ, Ismail Mohd Saiboon, Damage control resuscitation, characterized by hemostatic resuscitation with blood products, rapid arrest of bleeding and when possible, permissive hypotension with restricted fluid load form a structured approach in managing a polytrauma patient. When complicated with traumatic rhabdomyolysis however, permissive hypotension strategy may cause more harm resulting in subsequent ischaemicreperfusion injury and acute kidney injury. We present a case involving a 20-yearold man who was rolled over by a lorry and sustained an open unstable pelvic fracture with vascular injury and left lower limb ischaemia. Permissive hypotension strategy was pursued for 4 hours prior to bleeding control in OT. This was followed by protracted surgery of 6 hours. Coagulopathy, acute kidney injury and rhabdomyolysis ensued in the post-operative period and patient succumbed to his injury on Day 3 post-trauma. Challenges and pitfalls in managing a complex polytrauma patient and recent evidences on damage control resuscitation is discussed. Pusat Perubatan Universiti Kebangsaan Malaysia 2018 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/20219/1/26_ms0199_pdf_15364.pdf Farah NA, and Johar MJ, and Ismail Mohd Saiboon, (2018) Doing less is better : challenges in complex polytrauma management - case report. Medicine & Health, 13 (1). pp. 251-258. ISSN 2289-5728 https://www.medicineandhealthukm.com/toc/13/1 |
| spellingShingle | Farah NA, Johar MJ, Ismail Mohd Saiboon, Doing less is better : challenges in complex polytrauma management - case report |
| title | Doing less is better : challenges in complex polytrauma management - case report |
| title_full | Doing less is better : challenges in complex polytrauma management - case report |
| title_fullStr | Doing less is better : challenges in complex polytrauma management - case report |
| title_full_unstemmed | Doing less is better : challenges in complex polytrauma management - case report |
| title_short | Doing less is better : challenges in complex polytrauma management - case report |
| title_sort | doing less is better : challenges in complex polytrauma management - case report |
| url | http://journalarticle.ukm.my/20219/1/26_ms0199_pdf_15364.pdf http://journalarticle.ukm.my/20219/ https://www.medicineandhealthukm.com/toc/13/1 |
| url_provider | http://journalarticle.ukm.my/ |