Airway management in penetrating thoracic trauma

Abstract

Approximately 20-25% of deaths due to trauma in the first four decades of life result from thoracic trauma [1]. Penetrating thoracic trauma is present in 33% of deaths due to thoracic trauma [2]. in a 1972 autopsy study involving 1178 trauma patients, 82% of the patients with tracheobronchial injuries died at the accident site; 30% of those who could come to the hospital also died. it was observed that 50% of these losses occurred in the first hour [3].Between 2001 and 2005, a total of 1033 tracheal injuries were reported over five years in Germany [4]. According to the US Centers for Disease Control and Prevention (CDC), while the medical costs of approximately 12 000 patients who died in 2005 due to firearm assault injury were more than $60 million, it was reported that the loss of work and productivity was 18 billion dollars. Between 2000 and 2005, the average hospital cost for adults over the age of 18 who had a penetrating injury was estimated at £7983 in the UK [5]. it was observed that mortality in thoracic trauma patients was 36% before 1950 and decreased to 9% after 1970 [6].

Tracheobronchiale Verletzungen

“…Stumpfe TTV machen ca. 66-81 % der TTV aus [11,30,31] und entstehen im Rahmen von Thoraxtraumata durch Verkehrsunfälle, Stürze und Verschüttungen. Insgesamt soll die Inzidenz einer TTV nach stumpfem Thoraxtrauma bei 2,1-5,3% liegen [16].…”

“…Die absolute Basismaßnahme in der Versorgung der Patienten stellt in jedem Fall die Sicherung des Atemweges dar. Hierbei ist ein gemeinsames Management durch Anästhesie und Chirurgie anzustreben und neben der Intubation ist ebenfalls eine extrakorporale Membranoxygenierung zur Oxygenierung und Decarboxygenierung der Patienten in Betracht zu ziehen [33,34,35].…”

Trauma penetrante em tórax ferida com arma branca

“…As consequências e o manejo do trauma torácico penetrante dependem principalmente da extensão da lesão aos órgãos internos, bem como da habilidade dos médicos, obstrução das vias aéreas, insuficiência respiratória e sangramento. (Cakmak G. et al,2022)…”