Journal article
Updated APSA Guidelines for the Management of Blunt Liver and Spleen Injuries
JOURNAL OF PEDIATRIC SURGERY, v 58(8), p1411
Aug 2023
PMID: 37117078
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Non-operative management of blunt liver and spleen injuries was championed initially in children with the first management guideline published in 2000 by the American Pediatric Surgical Association (APSA). Multiple articles have expanded on the original guidelines and additional therapy has been investigated to improve care for these patients. Based on a literature review and current consensus, the management guidelines for the treatment of blunt liver and spleen injuries are presented.Methods: A recent literature review by the APSA Outcomes committee [2] was utilized as the basis for the guideline recommendations. A task force was assembled from the APSA Committee on Trauma to review the original guidelines, the literature reported by the Outcomes Committee and then to develop an easy to implement guideline. Results: The updated guidelines for the management of blunt liver and spleen injuries are divided into 4 sections: Admission, Procedures, Set Free and Aftercare. Admission to the intensive care unit is based on abnormal vital signs after resuscitation with stable patients admitted to the ward with minimal restrictions. Procedure recommendations include transfusions for low hemoglobin (<7 mg/dL) or signs of ongoing bleeding. Angioembolization and operative exploration is limited to those patients with clinical signs of continued bleeding after resuscitation. Discharge is based on clinical condition and not grade of injury. Activity restrictions remain the same while follow-up imaging is only indicated for symptomatic patients.Conclusion: The updated APSA guidelines for the management of blunt liver and spleen injuries present an easy-to-follow management strategy for children. Level of Evidence: Level 5.& COPY; 2023 Published by Elsevier Inc.
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Details
- Title
- Updated APSA Guidelines for the Management of Blunt Liver and Spleen Injuries
- Publication Details
- JOURNAL OF PEDIATRIC SURGERY, v 58(8), p1411
- Publisher
- W B SAUNDERS CO-ELSEVIER INC; PHILADELPHIA
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:001047386200001
- Scopus ID
- 2-s2.0-85153802473
- Other Identifier
- 991021860730504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Pediatrics
- Surgery