Blunt thoracic trauma

Parry, Neil; Moffat, Bradley; Vogt, Kelly

doi:10.1097/mcc.0000000000000251

Cited by 14 publications

(4 citation statements)

References 30 publications

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“…Furthermore, ECMO often triggers systemic inflammation, which should be considered if the inflammatory response to polytrauma will be analyzed 56 . For patients requiring intubation, airway pressure release ventilation is an excellent mode to decrease the risk of acute lung injury 57 . On the other hand, in the present study, the observational time period was very narrow.…”

Section: Discussionmentioning

confidence: 99%

Traumatic injury pattern is of equal relevance as injury severity for experimental (poly)trauma modeling

Yang

Bundkirchen

Krettek

et al. 2019

Sci Rep

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This study aims to elaborate the relevance of trauma severity and traumatic injury pattern in different multiple and/or polytrauma models by comparing five singular trauma to two different polytrauma (PT) models with high and one multiple trauma (MT) model with low injury-severity score (ISS). The aim is to provide a baseline for reducing animal harm according to 3Rs by providing less injury as possible in polytrauma modeling. Mice were randomly assigned to 10 groups: controls (Ctrl; n = 15), Sham (n = 15); monotrauma groups: hemorrhagic shock (HS; n = 15), thoracic trauma (TxT; n = 18), osteotomy with external fixation (Fx; n = 16), bilateral soft tissue trauma (bSTT; n = 16) or laparotomy (Lap; n = 16); two PT groups: PT I (TxT + HS + Fx; ISS = 18; n = 18), PT II (TxT + HS + Fx + Lap; ISS = 22; n = 18), and a MT group (TxT + HS + bSTT + Lap, ISS = 13; n = 18). Activity and mortality were assessed. Blood gas analyses and organ damage markers were determined after 6 h. Significant mortality occurred in TxT, PT and MT (11.7%). Activity decreased significantly in TxT, HS, both polytrauma and MT vs . Ctrl/Sham. PT-groups and MT had significantly decreased activity vs . bsTT, Lap or Fx. MT had significantly lower pCO 2 vs . Ctrl/Sham, Lap or bsTT. Transaminases increased significantly in PT-groups and MT vs . Ctrl, Sham or monotrauma. Traumatic injury pattern is of comparable relevance as injury severity for experimental multiple or (poly)trauma modeling.

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Section: Discussionmentioning

confidence: 99%

Traumatic injury pattern is of equal relevance as injury severity for experimental (poly)trauma modeling

Yang

Bundkirchen

Krettek

et al. 2019

Sci Rep

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“…However, patients could be admitted to the hospital in the early stages of trauma. Early application of NIV alleviated pulmonary edema and prevented its development, and shortened the duration of ventilatory support 18,41 . This study serves to broaden the indications for helmet use and provides a new option for patients with chest trauma in addition to NIV with a face mask 37 and high-flow nasal cannula therapy 42,43 .…”

Section: Discussionmentioning

confidence: 99%

Noninvasive ventilation with a helmet in patients with acute respiratory failure caused by chest trauma: a randomized controlled trial

Liu

Shan

Zhu

et al. 2020

Sci Rep

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Noninvasive ventilation (NIV) is beneficial in acute respiratory failure (ARF) caused by chest trauma; however, NIV-related complications affect the efficacy. We evaluated whether NIV with helmet decreases the incidence of complications and improves its effects in a single center. Patients with ARF after chest trauma were randomized to receive NIV with helmet or face mask. The primary outcome was the rate of NIV-related complications. Secondary outcomes were PaO2/FiO2, patient’s tolerance, intubation rate, length of intensive care unit (ICU) stay, and ICU mortality. The trial was terminated early after an interim analysis with 59 patients. The incidence of complications was lower in the helmet group [10% (3/29) vs 43% (13/30), P = 0.004], and PaO2/FiO2s were higher at 1 h and at the end of NIV (253.14 ± 64.74 mmHg vs 216.06 ± 43.86 mmHg, 277.07 ± 84.89 mmHg vs 225.81 ± 63.64 mmHg, P = 0.013 and 0.012) compared with them in face mask group. More patients reported excellent tolerance of the helmet vs face mask after 4 h of NIV [83% (24/29) vs 47% (14/30), P = 0.004] and at the end of NIV [69% (20/29) vs 30% (9/30), P = 0.03]. Differences in intubation rate, ICU stay, and mortality were non-significant (P = 0.612, 0.100, 1.000, respectively). NIV with helmet decreased NIV-related complications, increased PaO2/FiO2, and improved tolerance compared with NIV with face mask in patients with chest trauma.Trial registration: Registered in the Chinese Clinical Trial Registry (ChiCTR1900025915), a WHO International Clinical Trials Registry Platform (http://www.chictr.org.cn/searchprojen.aspx).

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“…Entre los hallazgos radiográficos se describen: el ensanchamiento mediastinal (≥ 8 cm), lateralización de la tráquea o esófago a la derecha, pérdida del contorno aórtico normal, pérdida de la ventana aortopulmonar, opacidad pleural apical y depresión del bronquio principal izquierdo 14 . Otros hallazgos, como la presencia de fracturas claviculares y vertebrales torácicas, pueden indicar un trauma con cinemática de alta energía [14][15][16][17] .…”

Section: Rayos X De Tóraxunclassified

“…Se debe tener en cuenta que la imagen puede ser normal en un 7 % a 13 % de los casos. Ninguno de los hallazgos descritos es específico de la lesión y, de forma independiente, el hallazgo de ensanchamiento mediastinal tiene una sensibilidad para la detección de lesión del 33 % [14][15][16][17][18] .…”

Section: Rayos X De Tóraxunclassified

Trauma cerrado de aorta torácica, desde el servicio de urgencias hasta el quirófano: revisión narrativa

Zuluaga Ramírez,

Mesa Arango,

Baena Jaramillo

et al. 2024

MedUPB

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El trauma es la principal causa de muerte de la población en edad productiva. El abordaje del trauma torácico cerrado todavía es un desafío para el médico de urgencias. Aunque no es una entidad frecuente, se asocia con una alta mortalidad y resultados adversos. El diagnóstico del trauma cerrado de aorta torácica (LCAT) requiere un alto índice de sospecha, dado que los signos y síntomas no son específicos de esta enfermedad (dolor torácico, dolor interescapular, disnea, disfagia, estridor, disfonía). Es importante resaltar que la ausencia de inestabilidad hemodinámica no debe descartar una lesión aórtica. Para su diagnóstico imagenológico se debe tener en cuenta que los rayos X de tórax no tienen el rendimiento adecuado, el patrón de referencia es la angiotomografía y el ecocardiograma transesofágico (ETE) constituye una opción diagnóstica. El manejo incluye líquidos endovenosos y antihipertensivos como medida transitoria, manejo quirúrgico definitivo y, en algunos casos, manejo expectante o diferido. Los pacientes inestables o con signos de ruptura inminente deben ser llevados de manera inmediata a cirugía. El manejo quirúrgico temprano ha impactado en la mortalidad. A pesar de los avances en las técnicas quirúrgicas, la técnica quirúrgica abierta documenta mayor tasa de mortalidad que el manejo endovascular, el cual tiene numerosas ventajas al ser poco invasivo. Esta es una revisión narrativa que destaca algunos aspectos clave sobre los mecanismos de lesión, diagnóstico y manejo inicial del trauma cerrado aorta torácica. Por último, se propone un algoritmo de abordaje de trauma de aorta.

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Blunt thoracic trauma

Cited by 14 publications

References 30 publications

Traumatic injury pattern is of equal relevance as injury severity for experimental (poly)trauma modeling

Traumatic injury pattern is of equal relevance as injury severity for experimental (poly)trauma modeling

Noninvasive ventilation with a helmet in patients with acute respiratory failure caused by chest trauma: a randomized controlled trial

Trauma cerrado de aorta torácica, desde el servicio de urgencias hasta el quirófano: revisión narrativa

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