Management of Traumatic Lung Injury : A Western Trauma Association Multicenter Review

Karmy‐Jones, Riyad; Jurkovich, Gregory J.; Shatz, David V.; Brundage, Susan I.; Wall, Mathew J.; Engelhardt, Sandra; Hoyt, David B.; Holcroft, John; Knudson, M. Margaret

doi:10.1097/00005373-200112000-00004

Cited by 105 publications

(79 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, within the entire cohort of patients who sustain severe thoracic trauma, only a small percentage will require operative intervention to control pulmonary hemorrhage (Table 1). In a multicenter retrospective review from five Level I Trauma Centers, Karmy-Jones and colleagues reported 31 % of patients who required a thoracotomy required operative intervention to stop pulmonary hemorrhage [16] with one quarter requiring a major resection (lobectomy or pneumonectomy). Several possible reasons exist for this relatively higher rate of lung resection in this retrospective series and include (1) a greater percentage of gunshot wounds, (2) a very high rate of thoracotomies for blunt trauma (36 %), (3) possible selection bias in that more severely injured patients were treated by these Level I Trauma Centers and/or, (4) that these trauma centers who participated in the study have an active interest in the topic and may have more liberal operative indications.…”

Section: Data Reported By Martin Et Al From the Ntdb 2003 Found Thatmentioning

confidence: 99%

“…An approach that has become the Bstandard^in the past two decades is to preserve as much lung as possible using pulmonary tractotomy or limited non-anatomic lung resections in order to accomplish the two goals mentioned above [16,21,22]. This approach should not be construed as a mandate to save pulmonary parenchyma at the expense of rapidly controlling bleeding.…”

Section: Operative Approachmentioning

confidence: 99%

“…The need for traumatic pneumonectomy is uncommon and is associated with mortality rates ranging from 50 to 100 % [6,16,25]. One hypothesis for the excessive mortality was the combination of hemorrhagic shock and the sudden increase in pulmonary vascular resistance that results in sudden and often irreversible right heart failure, which can lead rapidly to cardiac arrest [26].…”

Section: Operative Approachmentioning

confidence: 99%

See 2 more Smart Citations

Operative Management of Lung Injuries

Livingston

2015

Curr Trauma Rep

View full text Add to dashboard Cite

The need for operative management of pulmonary injury is uncommon. However, delaying patients requiring a thoracotomy for trauma increases morbidity and mortality; thus, the key aspect in management in this patient population is timely an operative intervention. Once the decision is made to perform a thoracotomy, the goal is to obtain control of hemorrhage as soon as possible. Lung lacerations from penetrating trauma usually have a tract though the pulmonary parenchyma and are usually amenable to lung-sparing techniques such as tractotomy or limited resections. Injuries from blunt trauma usually result in more significant tearing of the lung and are more likely to require larger resections. With modern approach to resuscitation, it is more important to quickly control hemorrhage than to worry about removing Btoo much lung.^Damage control techniques including temporary hilar clamping and chest packing are useful adjuncts to achieve survivorship in those patients with extensive chest trauma.

show abstract

Section: Data Reported By Martin Et Al From the Ntdb 2003 Found Thatmentioning

confidence: 99%

Section: Operative Approachmentioning

confidence: 99%

Section: Operative Approachmentioning

confidence: 99%

See 1 more Smart Citation

Operative Management of Lung Injuries

Livingston

2015

Curr Trauma Rep

View full text Add to dashboard Cite

show abstract

“…It is estimated that about 25% of traumatic deaths are secondary to thoracic injuries (2) and blunt chest trauma is associated with a higher mortality rate than penetrating chest injuries (3)(4)(5). lung resections performed for thoracic trauma is very low and the mortality rate associated with lobectomy reaches 60% (4,5).…”

Section: Introductionmentioning

confidence: 99%

“…lung resections performed for thoracic trauma is very low and the mortality rate associated with lobectomy reaches 60% (4,5).…”

Section: Introductionmentioning

confidence: 99%