[A life-saving approach after thoracic trauma: emergency room thoracotomy].

BACKGROUND In this article, the outcomes, indications and methods of emergency department service resuscitative thoracotomy in cardiac and/or respiratory arrest patients after thoracic trauma are discussed. METHODS Between January 2004 and December 2010, nine resuscitative thoracotomies were performed after thoracic trauma in the emergency department of our hospital. The records of the patients were evaluated retrospectively. RESULTS A total of nine patients underwent resuscitative thoracotomy: five stab wounds, two traffic accidents, one fall from height, and one gunshot wound. Anterolateral thoracotomy in supine position was performed in all. Three patients had lung parenchymal laceration, three patients had cardiac laceration, two patients had intercostal vessel injury, and one patient had descending aorta injury. None of the four patients with blunt trauma recovered. Three of five patients with penetrating trauma were discharged after an average of eight days of follow-up, whereas two of them were lost perioperatively. CONCLUSION Emergency room thoracotomy can be performed in thoracic trauma cases who are in shock and have unresponsive hypotension despite large volume fluid and blood replacement and no time for transportation to the operating room. The results are better in penetrating trauma patients than in blunt trauma.

[1]  C. Klodell.  Appropriate Use of Emergency Department Thoracotomy: Implications for the Thoracic Surgeon , 2012 .

[2]  P. Keskinoğlu,et al.  [A motivating experience for emergency medical services: the first Turkish Ambulance Rally]. , 2009, Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES.

[3]  K. Søreide,et al.  Resuscitative emergency thoracotomy in a Scandinavian trauma hospital--is it justified? , 2007, Injury.

[4]  M. Eryilmaz,et al.  [Remarks of 52 physicians participating into 8th Ankara Emergency Rooms (ERs) Meeting 2005 on resuscitative thoracotomy intervention]. , 2006, Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES.

[5]  Ernest E Moore,et al.  Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes , 2006, World journal of emergency surgery : WJES.

[6]  T. Coats,et al.  Emergency thoracotomy: “how to do it” , 2004, Emergency Medicine Journal.

[7]  E. Moore,et al.  Emergency department thoracotomy following injury: Critical determinants for patient salvage , 1988, World Journal of Surgery.

[8]  Jin-mou Gao,et al.  Penetrating Cardiac Wounds: Principles for Surgical Management , 2004, World Journal of Surgery.

[9]  P. Rhee,et al.  Survival after emergency department thoracotomy: review of published data from the past 25 years. , 2000, Journal of the American College of Surgeons.

[10]  L. Jacobson,et al.  Penetrating chest trauma: should indications for emergency room thoracotomy be limited? , 1996, The American surgeon.

[11]  A. Bleetman,et al.  Review of emergency thoracotomy for chest injuries in patients attending a UK Accident and Emergency department. , 1996, Injury.

[12]  H. Champion,et al.  Predictors of outcome in patients who have sustained trauma and who undergo emergency thoracotomy. , 1993, Archives of surgery.

[13]  K. Mattox,et al.  Epidemiology of chest trauma. , 1989, The Surgical clinics of North America.

[14]  D. Feliciano,et al.  Liberal use of emergency center thoracotomy. , 1986, American journal of surgery.

[15]  F. W. Blaisdell,et al.  The role of emergency thoracotomy in blunt trauma. , 1982, The Journal of trauma.

[16]  E. Moore,et al.  Emergency department thoracotomy. , 1979, JACEP.

[17]  K. Mattox,et al.  Cardiorrhaphy in the emergency center. , 1974, The Journal of thoracic and cardiovascular surgery.

[18]  W. Logan,et al.  PENETRATING CARDIAC INJURIES. , 1964, The American surgeon.