Recommendations of Wahlstrom et al for Management of a Trauma Patient with Cirrhosis

 

Patient selection: Trauma patients with cirrhosis who required emergency laparotomy for intra-abdominal injuries.

 

Basic principle: The patients need to be closely and aggressively managed since there is no margin for error. Serious problems may occur in patients with seemingly minor injuries.

 

Management suggestions:

(1) transport to a major trauma center for treatment

(2) promptly diagnose injuries

(3) definitively treat injuries

(4) early and aggressive management of coagulation disorders (vitamin K, FFP, etc.)

(5) avoid hypothermia

(6) avoid unnecessary blood transfusions

(7) early nutritional support as appropriate, especially in patients with hypoalbuminemia

 

NOTE: These principles should apply to any trauma patient with cirrhosis.