Western Trauma Association
Management of Adult Blunt Hepatic Trauma
Annotation
for Point I
Carillo
et al.35 proposed criteria for nonoperative
management of hepatic trauma to include: hemodynamically
stable (not defined) patients with liver injuries
diagnosed on CT scan, hepatic-related transfusion
limited to 4 units of blood, and absence of other
abdominal injuries that required exploration. The
hepatic-related transfusion limit has not been verified.
The morbidity of ongoing transfusions in an otherwise
hemodynamically stable patient versus the morbidity of
hepatic surgery remains to be well defined. Transfusion
requirement in the first 24 hours postinjury has been
shown to predict the development of liver-related
complications.36