Cardiothoracic trauma

Symbas, Panagiotis N.

doi:10.1016/0011-3840(91)90045-q

Cited by 36 publications

(37 citation statements)

References 85 publications

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“…Survival following penetrating trauma is often dependent on the state of the pericardial wound. [7] When the pericardial wound is open and blood is able to flow freely into the pleural space, the patient can often be supported with fluid resuscitation and chest tube thoracostomy. Persistent drainage from the thoracostomy tube should warn of possible cardiac injury and surgical exploration is indicated.…”

Section: Penetrating Traumamentioning

confidence: 99%

“…Repair of the myocardium should be done with interrupted sutures utilizing pledgets and performed in a horizontal mattress fashion [7,8]. Injuries to small coronary arteries can be treated with simple ligation.…”

Section: Figure 1 Algorithm For the Management Of Penetrating Cardiamentioning

confidence: 99%

“…Larger coronary arteries require either direct repair or bypass and the operating room should be capable of cardiopulmonary bypass (CPB). [7] Intracardiac injuries require CPB to be definitively addressed.…”

Section: Figure 1 Algorithm For the Management Of Penetrating Cardiamentioning

confidence: 99%

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Cardiac Trauma

Eiferman¹,

Nathan²,

Firstenberg³

2013

Principles and Practice of Cardiothoracic Surgery

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Section: Penetrating Traumamentioning

confidence: 99%

Section: Figure 1 Algorithm For the Management Of Penetrating Cardiamentioning

confidence: 99%

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Cardiac Trauma

Eiferman¹,

Nathan²,

Firstenberg³

2013

Principles and Practice of Cardiothoracic Surgery

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“…2,3 and subsequent abdominal distension and presence of significant vascular injuries. 4 several studies observed inaccuracies in clinical diagnosis by physical examination due to altered levels of consciousness due to alcohol, drugs or neurological deficits. 5,6 Systemic evaluation and diagnostic modalities should go hand in hand; diagnostic peritoneal tapping is considered safe initial diagnostic technique with high accuracy.…”

Section: Introductionmentioning

confidence: 99%

Inadequacy in Diagnosis of Blunt Trauma Abdomen - Can Anaesthesiologist Be Baffled by Catastrophic Intraoperative Findings?

Choudhury¹,

Saloi²

2015

jemds

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ABSTRACT:The magnitude of injury inflicted by Blunt trauma abdomen has varied manifestations ranging from minor single-system injury to devastating, multi-system injury .Blunt trauma abdomen alone or in association with polytrauma is a frequent presentation in the emergency department. High index of suspicion and clinical acumen is required during evaluation of blunt abdominal injuries because physical signs and symptoms indicating presence of visceral lesions may poorly correlate with clinical presentation. Diagnostic peritoneal tapping is considered safe initial option with high accuracy but carries possibility of significant false positive and false negative result. Ultrasonography (FAST) has its own limitations; although CT findings can be conclusive it involves time for analysis and the patient should be cooperative. Blunt trauma abdomen may present with life threatening internal haemorrhage due to visceral or vascular injuries prompting emergency surgical intervention at odd hours with limited investigations and resources, Pre anaesthetic optimization by maintenance of adequate tissue oxygenation with optimal blood volume replacement and judicious use of inotropes, determine outcome of such emergency procedures. Careful selection of anaesthetic techniques and drugs particularly the inducing agents can be life-saving. Agility of the attending anesthesiologist to handle unforeseen intra operative critical events plays a pivotal role in overall outcome. We are discussing Anaesthetic management of a 23 year old victim of road traffic accident, who sustained blunt trauma abdomen about 24 hrs. Back, was conscious, oriented and ambulatory till the time of shifting to the operating theatre but on exploration sudden gush of blood from a preoperatively undetected 7 cms long tear of the sub diaphragmatic part of IVC, and lacerated liver almost exsanguinated the patient.

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“…Before arrival at Emergency Department. 1,2 Survival of patients with cardio thoracic injuries depend on nature and extent of injuries, pre hospital support, treatment and status of the patient on admission. 2 High degree of suspicion and clinical acumen is required during evaluation of penetrating thoracic injuries because; clinical signs of pulse deficit or murmur may be absent despite presence of significant vascular injuries.…”

Section: Introductionmentioning

confidence: 99%

Anaesthetic Management of a Patient With Penetrating Thoracic and Cardiac Injuries in Emergency Department

Choudhury¹,

Saloi²

2015

jemds

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Thoracic injuries may be associated with life threatening cardiac injury necessitating immediate surgical intervention in an emergency operation theatre at odd hours with limited investigations and resources. Pre Anaesthetic optimization by maintenance of adequate tissue oxygenation with optimal blood volume replacement and judicious use of inotropes, determine outcome of such emergency procedures. Careful selection of Anaesthetic techniques and drugs particularly the inducing agents like Ketamine hydrochloride can be life-saving. We are discussing Anaesthetic management of a 24 year old victim of road traffic accident brought to the Emergency Department in a state of unconsciousness and shock due to penetrating chest injury with multiple rib fractures, pleural laceration, pericardial laceration and diaphragmatic tear. The patient was put up for emergency exploration and repair. CT scan ruled out head injury and Abdomen was soft and ultrasound detected no obvious intra-abdominal injury or collections.

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Cardiothoracic trauma

Cited by 36 publications

References 85 publications

Cardiac Trauma

Cardiac Trauma

Inadequacy in Diagnosis of Blunt Trauma Abdomen - Can Anaesthesiologist Be Baffled by Catastrophic Intraoperative Findings?

Anaesthetic Management of a Patient With Penetrating Thoracic and Cardiac Injuries in Emergency Department

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