APPROACH TO ASSESSMENT AND MANAGEMENT OF BLEEDING RISK IN LONG BONE TRAUMA: A COMPREHENSIVE BIBLIOGRAPHICAL REVIEW

• DOI: https://doi.org/10.22533/at.ed.159442409019

• Palavras-chave: Long bone fractures, Bleeding complications, Early identification, Therapeutic approaches.

• Keywords: Long bone fractures, Bleeding complications, Early identification, Therapeutic approaches.

• Abstract:

  Objective: To carry out an analysis of the clinical profile of patients prone to bleeding complications after long bone fractures, focusing on early identification. Furthermore, evaluate therapeutic approaches aimed at preventing, controlling and minimizing damage. Methodology: An integrative review was conducted using the PubMed database and the descriptors "Long Bone Fractures" and "Hemorrhage", combined with the Boolean operator "AND", resulting in 60 initial articles. After applying inclusion and exclusion criteria, 10 articles were selected to compose the study. Discussion: Post-trauma hemorrhagic complications represent risk factors for the lethal triad composed of hypothermia, metabolic acidosis and coagulopathy. In the context of pelvic fractures, a mortality rate above 30% is observed. Antifibrinolytic therapy, particularly tranexamic acid, demonstrates benefit in selected cases by blocking post-traumatic hyperfibrinolysis. Damage control surgery, in turn, contributes to reducing hospitalization time and complications. Fixation in the first 24 hours has a positive impact on the prognosis, although it can be harmful if the intervention lasts for more than 90 minutes. Conclusion: Given these considerations, the diversity of therapeutic options available is understood, highlighting the importance of a personalized approach. Furthermore, the need for more robust data for the development of protocols to improve clinical practices is highlighted.