Decision-making of hemorrhagic shock patients with intraperitoneal bleeding (IPB) by ultrasonography (US): the importance of early detection of an increase of IPB

Excerpt

Hemorrhagic shock patients with abdominal trauma require immediate decision-making of treatment; laparotomy or not. If IPB is massive, we have to do a laparotomy; and if it is little or not increasing, we need not. Emergency transcatheter arterial embolization (E-TAE) is a more common therapeutic procedure in Japan, compared with in European countries. E-TAE contributes towards the avoidance of unnecessary laparotomy. However, a patient who underwent E-TAE is fully covered and we cannot watch the abdomen of the patient. We can evaluate the patient's condition only by heart rate and blood pressure, often resulting in a lethal delay in decision-making. Recently we evaluated the increase of IPB during E-TAE by portable US (PUS), which is usually used for bedside examination or out-of-hospital evaluation. The aim of this study is to clarify the usefulness of PUS for decision-making during E-TAE and safety of E-TAE under monitoring by portable US. …