Large vessels

Injury to the inferior vena cava leads to massive hemorrhage and is associated with mortalities of 21 to 66 per cent in patients reaching the hospital alive. Retrohepatic caval injuries are difficult to control, leading to extensive blood loss, hypothermia, coagulation disorders, and subsequent organ failure, if not death. Temporary vascular isolation of the liver, using a Pringle maneuver for liver hilus occlusion together with an atrial-caval shunt, permits the surgeon to repair the caval injury or perform ligation of hepatic veins with partial liver resection.

Major aortic or large arterial injury is usually less difficult to control. The aorta can be clamped supradiaphragmatically through a left thoracotomy, infradiaphragmatically, or infrarenally.

Sleep Apnea

Sleep Apnea

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