Management of Pediatric Cardiac Trauma in the ED

Kamdar, Gunjan; Santucci, Karen A.; Emerson, Beth

doi:10.1016/j.cpem.2011.09.001

Cited by 6 publications

(4 citation statements)

References 51 publications

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“…Cardiac contusion (CC) is a potentially deadly complication of blunt thoracic trauma. [1] The rate of blunt cardiac injuries after thoracic traumas has been reported in the range of 5-50%. [2,3] Cardiac and major vascular injuries occurring sis, vasoconstriction, and valve defects.…”

Section: Introductionmentioning

confidence: 99%

Effects of Amifostine against Blunt Chest Trauma-Induced Cardiac Injury in Rats

Acıpayam¹

2023

Ulus Travma Acil Cerrahi Derg

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BACKGROUND:This study aimed to examine whether two different doses of dexamethasone (DXM), which is a corticosteroid, and amifostine (AMI), which reduces cumulative tissue toxicity induced by cisplatin in advanced-stage cancer patients, have ameliorative effects on pathologic changes associated with cardiac contusion (CC) induced in rats. METHODS:Forty-two Wistar albino rats were equally divided into six groups (n=7): C, CC, CC+AMI 400, CC+AMI 200, CC+AMI+DXM, and CC+DXM. Tomography images and electrocardiographic analyzes were performed, mean arterial pressure was measured from the carotid artery, and blood and tissue samples were obtained for histopathological and biochemical analyses after trauma-induced CC. RESULTS:While the total oxidant status and disulfide parameters in the cardiac tissue and serum were significantly higher (p<0.05), the total antioxidant status, total thiol, and native thiol parameters were significantly lower (p<0.01) in rats with trauma-induced CC. The most frequently observed finding in the electrocardiography analyze was ST elevation. CONCLUSION:According to evaluation based on histological, biochemical, and electrocardiographic examinations, we believe that only 400 mg/kg dose of AMI or DXM can be effective in the treatment of myocardial contusion in rats. Evaluation based on histological findings.

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Section: Introductionmentioning

confidence: 99%

Effects of Amifostine against Blunt Chest Trauma-Induced Cardiac Injury in Rats

Acıpayam¹

2023

Ulus Travma Acil Cerrahi Derg

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“…Acute cardiac contusion results from non-penetrating chest trauma such as motor vehicle accidents, sports injuries, and falls from height. [ 1 ] The heart is squeezed between the ribcage and the spine with a high-energy impact effect,[ 2 ] and this compression causes damage in cardiac structures, decreases in coronary blood flow,[ 3 ] and life-threatening arrhythmias. [ 4 ] According to experimental trauma models, mitochondrial dysfunction[ 5 ] and an increase in reactive oxygen radicals (ROS) occur in myocardial cells, in which blood flow and oxygenation are impaired.…”

Section: Introductionmentioning

confidence: 99%

The effect of rutin on experimentally induced acute heart contusion in rats. Biochemical and histopathological evaluation

Elma¹

2021

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Acute cardiac contusion induced by trauma is known with its high mortality and morbidity. The role of oxidative stress and inflammation in its pathophysiology has led to the investigation of antioxidant and anti-inflammatory substances in non-surgical treatment. In this study, the effects of rutin which has these two features on acute cardiac contusion were investigated. METHODS: Thirty male albino Wistar rats were divided into three equal groups as healthy (HG), contusion (CG), and rutin + contusion (rutin + CG). A heart contusion was created dropping 200 g weight from 1-m height onto anterior thorax of CG (n=10) and Rutin + CG (n=10) group animals by anesthetizing with intraperitoneal administration of 60 mg/kg ketamine and xylazine inhalation at appropriate intervals. Thirty minutes after contusion was applied, rutin at the dose of 50 mg/kg was administered orally to the stomach by gavage to the rutin + CG group animals. The rutin was used once a day for 2 days. Rats were killed at the end of 48 h. Heart tissues were removed and examined biochemically and histopathologically. Troponin I (TP I) and creatine kinase-MB (CK-MB) were measured in blood samples taken from the tail veins just before the rats were killed. RESULTS: TP I, CK-MB, malondialdehyde, total oxidant status, and nuclear factor-kappa B levels increased in the CG when compared to the HG, and Rutin application prevented this increase, total glutathione (eGSH) and total antioxidant status levels decreased, and rutin application prevented this decrease. Histopathological findings also supported these findings. CONCLUSION: Rutin had a protective effect on heart tissue.

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“…Cardiac contusion is a potentially fatal complication of blunt chest trauma ( 1 ). Motor vehicle accidents are the most common cause of cardiac contusions ( 2 ), and the frequency of cardiac contusion ranges from 8% to 76% depending on the diagnostic criteria used after trauma ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…Blunt chest trauma may lead to cardiac injury including myocardial contusion, hematoma, ventricular rupture, ventricular septal defect, and valvular damage, or a decrease in coronary blood flow associated with vascular lesions, subintimal hemorrhage, intraluminal thrombosis, or vasoconstriction ( 1 , 5 ). Because cardiac contusion may potentially cause severe hemodynamic compromise and life-threatening arrhythmias ( 3 , 6 ), its accurate management is very important.…”

Section: Introductionmentioning

confidence: 99%

A combination of methylprednisolone and quercetin is effective for the treatment of cardiac contusion following blunt chest trauma in rats

Demir

Güzel

Kat

et al. 2014

Braz J Med Biol Res

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Cardiac contusion is a potentially fatal complication of blunt chest trauma. The effects of a combination of quercetin and methylprednisolone against trauma-induced cardiac contusion were studied. Thirty-five female Sprague-Dawley rats were divided into five groups (n=7) as follows: sham, cardiac contusion with no therapy, treated with methylprednisolone (30 mg/kg on the first day, and 3 mg/kg on the following days), treated with quercetin (50 mg·kg−1·day−1), and treated with a combination of methylprednisolone and quercetin. Serum troponin I (Tn-I) and tumor necrosis factor-alpha (TNF-α) levels and cardiac histopathological findings were evaluated. Tn-I and TNF-α levels were elevated after contusion (P=0.001 and P=0.001). Seven days later, Tn-I and TNF-α levels decreased in the rats treated with methylprednisolone, quercetin, and the combination of methylprednisolone and quercetin compared to the rats without therapy, but a statistical significance was found only with the combination therapy (P=0.001 and P=0.011, respectively). Histopathological degeneration and necrosis scores were statistically lower in the methylprednisolone and quercetin combination group compared to the group treated only with methylprednisolone (P=0.017 and P=0.007, respectively). However, only degeneration scores were lower in the combination therapy group compared to the group treated only with quercetin (P=0.017). Inducible nitric oxide synthase positivity scores were decreased in all treatment groups compared to the untreated groups (P=0.097, P=0.026, and P=0.004, respectively). We conclude that a combination of quercetin and methylprednisolone can be used for the specific treatment of cardiac contusion.

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Management of Pediatric Cardiac Trauma in the ED

Cited by 6 publications

References 51 publications

Effects of Amifostine against Blunt Chest Trauma-Induced Cardiac Injury in Rats

Effects of Amifostine against Blunt Chest Trauma-Induced Cardiac Injury in Rats

The effect of rutin on experimentally induced acute heart contusion in rats. Biochemical and histopathological evaluation

A combination of methylprednisolone and quercetin is effective for the treatment of cardiac contusion following blunt chest trauma in rats

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