Early diagnosis of penetrating cardiac and pleural injury by extended focused assessment with sonography for trauma

Singaravelu, KP; Saya, Rama Prakasha; Pandit, Vinay

doi:10.4103/1995-705x.201781

Cited by 3 publications

(6 citation statements)

References 7 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Trauma due to violent causes among the young population represents a significant portion of the demand of emergency surgical services, especially in large urban centers. Cardiac trauma can be classified as blunt or penetrating 1 , and according to current evidence, its mortality rate considering only the cases who don’t survive to reach the hospital ranges from 80% to 95% 1 , 2 , 4 , 5 . For the patients who do reach the hospital, it has been shown a predominance of this type of trauma in the young male population with a mean age of 30.8 years 7 , which roughly matches the data we found in our study, since 82% of the cases were men, although with a fairly higher mean age of 37.1 years.…”

Section: Discussionmentioning

confidence: 99%

“…These exams are preferred instead of troponin dosing, since the latter showed a sensitivity of only 23% 2 . Nevertheless, the most important tool for rapid assessment of cardiac 1 -Hospital do Trabalhador, General Surgery -Curitiba -PR -Brasil 2 -Faculdades Pequeno Príncipe, Faculty of Medicine -Curitiba -PR -Brasil trauma injuries in the emergency department, especially for hemodynamically unstable cases, is the FAST (Focused Assessment with sonography in trauma) exam 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Cardiac traumas are classified primarily by their mechanism of injury, which may be penetrating or non-penetrating (blunt cardiac injury). Blunt cardiac injury is reported as being the most common, being majorly caused by abrupt deceleration resulting from car accidents (50%), followed by pedestrian hit-and-run (35%), motorcycle accidents (9%) and falls from height (6%) 1 , 3 , while penetrating cardiac injuries are mostly due to stab wounds (59%), gunshot-injuries (26%) and other causes (15%) 4 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Epidemiological analysis of cardiac trauma victims at a referral trauma hospital: a 5 year case series

Sarquis¹,

Schultze²,

GAZOLA³

et al. 2022

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

Objective: to describe, analyze, and trace the epidemiological profile for cardiac trauma victims on a referral trauma hospital of a major urban center. Methods: a case series study to review, describe, compile and analyze medical records of all patients sustaining traumatic cardiac injuries, from January 2015 to January 2020 admitted to the referral trauma hospital of Curitiba, Brazil. Patients sustaining traumatic heart injuries were identified using the hospitals database. Patients who died prior to reaching hospital care were excluded. Results: all 22 cases were urban victims, mostly penetrating injuries (12 stab wounds, 9 gunshot wounds); 82% were male; mean age, 37.1 years. 17 cases (77%) occurred during night hours, 15 between Friday and Sunday, and 15 were admitted hemodynamically stable. Only 27% were diagnosed with FAST, the remainder requiring other imaging exams. About incisions, 14 had thoracotomies, 6 median sternotomies and in 2 cases both. Of injuries, 8 affected the right ventricle, 3 right atrium, 9 left ventricle, 1 right coronary sulcus and 1 anterior wall. All had cardiorrhaphy repair. 3 patients died, 17 were discharged and 2 were transferred. 17 received postoperative echocardiograms, revealing ejection fractions ranging 55.1% to 75%. Patients spent a mean of 9.6 days on ICU and a mean of 15.2 days of total hospital stay. The mortality rate was 14%. Conclusions: cardiac traumas predominantly occurred in adult males, due to violent causes, during night hours on weekends. The overall mortality rate found (14%), as well as total hospital stay, accords with the literature.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Epidemiological analysis of cardiac trauma victims at a referral trauma hospital: a 5 year case series

Sarquis¹,

Schultze²,

GAZOLA³

et al. 2022

Rev. Col. Bras. Cir.

View full text Add to dashboard Cite

show abstract

“…This CT-guided approach to diagnostic workup was shown to decrease the number of investigations, be beneficial from a cost perspective, and was not associated with higher rates of missed injuries ( 17 ). Finally, the technological improvements in bedside ultrasound and increasing provider experience with this modality have allowed for rapid and accurate assessment of the pericardium, decreasing the need for pericardial windows in the hemodynamically stable patient ( 18 ).…”

Section: Historical Perspectivementioning

confidence: 99%

Transmediastinal penetrating trauma

Jogiat¹,

Strickland²

2021

Mediastinum

View full text Add to dashboard Cite

Penetrating transmediastinal injury (TMI) is associated with a high mortality rate and presents a challenging diagnostic scenario. Previous dogma mandated surgical exploration or extensive and invasive investigations for all patients sustaining transmediastinal penetrating trauma, regardless of hemodynamic status. Since the late 1990s, the paradigm has changed, with most centers adopting a tiered approach to management based on clinical presentation. Transmediastinal penetrating trauma is a rare injury pattern and can result from gunshot wounds, stab wounds, blast injuries, and other missiles. The most predominant source, however, remains gunshot wounds, accounting for the vast majority of these injuries. A systematic approach in the emergency department to diagnosis and management should be undertaken and patients in extremis or with hemodynamic compromise rapidly identified. The unstable patient forgoes further investigations and the surgeon must use knowledge about the hypothesized trajectory, results of limited imaging, chest tube output, and anticipation of resuscitative maneuvers to select the best operative approach. In patients who are sufficiently stable to undergo CT angiogram (CTA) of the chest, the trajectory of the missile or impalement can often be deduced and this is used to guide further investigation or operation. In those where ambiguity remains, more focused tests such as echocardiography, pericardial window, esophagoscopy or esophagography, and bronchoscopy can be used to assess the mediastinal structures. For the stable patient, management proceeds with cautious and expeditious investigations to determine the extent of underlying organ-specific injuries. Thus, in patients with this injury pattern, determination of the patient’s clinical status is critical to determine the appropriate course of management.

show abstract

“…Alive patients have a variable clinical presentation at the emergency department with a pericardial tamponade in 70% of survivors and 20% of non-survivors [1]. Firearm and stab wounds are the most common causes of penetrating cardiac injury [2].…”

Section: Introductionmentioning

confidence: 99%

Delayed Pericardial Tamponade after Nail Gun Injury to the Right Ventricle

Ya¹

2019

SAJ Case Reports

View full text Add to dashboard Cite

Early diagnosis of penetrating cardiac and pleural injury by extended focused assessment with sonography for trauma

Cited by 3 publications

References 7 publications

Epidemiological analysis of cardiac trauma victims at a referral trauma hospital: a 5 year case series

Epidemiological analysis of cardiac trauma victims at a referral trauma hospital: a 5 year case series

Transmediastinal penetrating trauma

Delayed Pericardial Tamponade after Nail Gun Injury to the Right Ventricle

Contact Info

Product

Resources

About