Non-Operative Management of Adult Blunt
Hepatic Trauma Algorithm

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