Why is the lower torso protected in traumatic asphyxia? A new hypothesis

Thompson, Alan; Illescas, Fernando F.; Chiu, Ray C.‐J.

doi:10.1016/0003-4975(89)90279-8

Cited by 16 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Closure of the glottis with tightening of chest accessory muscles just before impact was thought to result in marked increase in intrathoracic pressure on compression, with transmission of this pressure into the valveless veins of the head and neck [1,19]. The lack of petechiae in the lower body may be due to the protective effects of valves in leg veins and possibly because of compression of the inferior vena cava in the chest [20].…”

Section: Discussionmentioning

confidence: 98%

The pathological features and circumstances of death of lethal crush/traumatic asphyxia in adults—A 25-year study

Byard

Wick

Simpson

et al. 2006

Forensic Science International

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 98%

The pathological features and circumstances of death of lethal crush/traumatic asphyxia in adults—A 25-year study

Byard

Wick

Simpson

et al. 2006

Forensic Science International

View full text Add to dashboard Cite

“…8 Alternatively, increased airway pressure may compress or obliterate the inferior vena cava to protect the lower part of the body. 9 Although cyanosis, petechia and edema were seen only in the upper part of his body, serum concentrations of liver enzymes increased and hematuria was observed in the present case. These abnormalities might have resulted from direct abdominal compression, as evidenced by the tire mark on the abdomen, and/or increased venous pressure transmitted to liver and kidney.…”

Section: Discussionmentioning

confidence: 37%

A traumatic asphyxia in a child

Nishiyama

Hanaoka

2000

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: Traumatic asphyxia in a child is rare and the pathophysiology is different from that occurring in an adult. We report a case of traumatic asphyxia in a child who recovered without specific treatment, even though chest and abdominal compression was severe.Clinical features: A three-year-old boy (14.2 kg) was run over by the rear wheel of a Jeep. He was under the tire for about three minutes and then was transferred to our hospital. When he arrived, he was lethargic with Glasgow Coma Scale of E3V4M6 (coma score of 13). He was cyanotic in his face and had a tire mark from the left shoulder to the right abdomen, petechia on the head, face, conjunctiva and chest, oral bleeding, and facial edema. Serum concentrations of liver enzymes were increased and microhematuria was detected. However, no injuries were seen in the brain, eye, chest, or abdomen. Cyanosis disappeared in a few hours. Facial and thoracic petechia disappeared in three days and that of the conjunctiva in five days. He was discharged from hospital on the 13th day without any disturbances. Conclusion:We present a three-year-old boy with traumatic asphyxia. He had no complications although he received severe thoraco-abdominal compression by a Jeep.Objectif: L'asphyxie traumatique, rare chez l'enfant, présente une physiopathologie différente de celle de l'adulte. Nous citons le cas d'un enfant qui a subi une asphyxie traumatique et qui a récupéré sans traitement particulier, même avec une compression thoracique et abdominale sévère.Éléments cliniques : Un garçon de 3 ans, (14,2 kg) a été écrasé sous une roue arrière d'un Jeep. Il s'est retrouvé sous le pneu pendant environ 3 min et a été conduit, par la suite, à notre hôpital. À son arrivée, il était léthargique et présentait une cote de E3V4M6 à l'échelle de Glasgow (score de coma de 13). Son visage était cyanosé et il avait une marque de pneu allant de l'épaule gauche à la partie droite de l'abdomen, des pétéchies à la tête, au visage, sur la conjonctive et la poitrine, un saignement buccal et un oedème facial. Les concentrations sériques d'enzymes hépatiques étaient augmentées et on a détecté une microhématurie. Cependant, aucune lésion n'a été observée au cerveau, aux yeux, au thorax ou à l'abdomen. La cyanose est disparue en quelques heures, les pétéchies faciales et thoraciques en trois jours et celles de la conjonctive en cinq jours. L'enfant a pu quitter l'hôpital au 13 e jour et ne présentait aucun trouble.Conclusion : Nous avons cité le cas d'un enfant de 3 ans qui a souffert d'asphyxie traumatique. Il n'a pas présen-té de complications même s'il a subi une sévère compression thoraco-abdominale.

show abstract

“…However, the sudden thoraco-abdominal compression in traumatic asphyxia causes acute incompetence of these valves resulting in characteristic venous discoloration of the head and neck. In contrast to this, the congestion and petechiae are not seen over lower body due to the inferior vena cava compression as a result of Valsalva maneuver produced subsequent to pre-impact fear response [11].…”

Section: Discussionmentioning

confidence: 97%