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https://www.readbyqxmd.com/read/29744222/chest-wall-stabilization-in-trauma-patients-why-when-and-how
#1
REVIEW
Jose Ribas Milanez de Campos, Thomas W White
Blunt trauma to the chest wall and rib fractures are remarkably frequent and are the basis of considerable morbidity and possible mortality. Surgical remedies for highly displaced rib fractures, especially in cases of flail chest, have been undertaken intermittently for more than 50 years. Rib-specific plating systems have started to be used in the last 10 years. These have ushered in the modern era of rib repair with chest wall stabilization (CWS) techniques that are safer, easier to perform, and more efficient...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29734833/changing-pattern-and-outcome-of-pediatric-chest-injuries-in-urban-syria
#2
Bassam Darwish, Mohammad Z Mahfouz, Saeed Al-Nosairat, Mohammad Bashar Izzat
Background Pediatric chest injuries were infrequent in our practice, but the outbreak of the Syrian crisis resulted in an increase in number and a change in the pattern of thoracic trauma incidents. We compared our experience of pediatric chest injuries before and during the crisis. Methods We reviewed the records of 256 children aged 12.8 ± 5 years who were admitted to our hospital with the diagnosis of chest trauma over a 12-year period. Collected data included mechanism of injury, associated injuries, method of management, length of hospital stay, complications, and mortality...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29727315/autopsy-features-of-fatal-donkey-attack
#3
Lajos Fogel, Gyula Varga, Marta Hubay, Endre Felszeghy, Peter Varga, Roger W Byard
Lethal donkey attacks have very rarely been described. The case of a 65-year-old man who was found deceased on a country road with 2 domestic donkeys nearby is, therefore, reported. Examination of the body revealed contusions and lacerations of the face and scalp, a comminuted fracture of the left maxilla, comminuted fracturing of the right radius and ulna and of the left anterior superior iliac spine, a flail chest, and pulmonary contusions. In addition, there were bite marks on the left thigh, right buttock, right axilla/upper arm, and left cheek which corresponded to the dental arcades of the donkeys...
May 2, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29725828/comparison-of-effect-of-dexmedetomidine-and-lidocaine-on-intracranial-and-systemic-hemodynamic-response-to-chest-physiotherapy-and-tracheal-suctioning-in-patients-with-severe-traumatic-brain-injury
#4
Shalendra Singh, Rajendra Singh Chouhan, Ashish Bindra, Nayani Radhakrishna
PURPOSE: Chest physiotherapy and tracheal suction cause sympathetic stimulation and increase heart rate (HR), mean arterial pressure (MAP) and intracranial pressure (ICP) which may have deleterious effect in the head injured. We planned to compare the effect of intravenous dexmedetomidine and lidocaine on intracerebral and systemic hemodynamic response to chest physiotherapy (CP) and tracheal suctioning (TS) in patients with severe traumatic brain injury (sTBI). METHODS: Prospective, randomized study in patients with sTBI, 18-60 years of age, undergoing mechanical ventilation and intraparenchymal ICP monitoring...
May 3, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29707289/fractures-of-the-manubrium-sterni-treatment-options-and-a-possible-classification-of-different-types-of-fractures
#5
Stefan Schulz-Drost, Sebastian Krinner, Pascal Oppel, Sina Grupp, Melanie Schulz-Drost, Friedrich F Hennig, Andreas Langenbach
Background: Sternum fractures are mostly located on the sternal corpus, seldom on the manubrium. Fractures of the sternal manubrium are, however, more frequently associated with severe concomitant injuries of thoracic organs, and therefore deserve special attention. In addition, in its function as a capstone in between the anterior chest wall and the shoulder girdle, it is exposed to a multiplicity of forces. Therefore the questions arise what types of fractures are observed in today's clinical practice, how to classify them and which treatment options are available...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29705114/review-of-interventions-and-radiation-exposure-from-chest-computed-tomography-in-children-with-blunt-trauma
#6
Victor Hsiao, Genevieve Santillanes, Daniel Malek, Ilene Claudius
OBJECTIVE: To determine the radiation risk to a child undergoing trauma evaluation with chest computed tomography (CCT) for every clinically actionable injury identified. STUDY DESIGN: This observational, cross-sectional study included all blunt trauma patients under 18 years of age undergoing CCT in a single urban emergency department. Via a retrospective chart review, therapeutic interventions done exclusively for chest injuries identified on CCT scan were identified...
April 25, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29700586/current-treatment-and-outcomes-of-traumatic-sternal-fractures-a-systematic-review
#7
REVIEW
Dorine S Klei, Mirjam B de Jong, F Cumhur Öner, Luke P H Leenen, Karlijn J P van Wessem
PURPOSE: Traumatic sternal fractures are rare injuries. The most common mechanism of injury is direct blunt trauma to the anterior chest wall. Most (> 95%) sternal fractures are treated conservatively. Surgical fixation is indicated in case of fracture instability, displacement or non-union. However, limited research has been performed on treatment outcomes. This study aimed to provide an overview of the current treatment practices and outcomes of traumatic sternal fractures and dislocations...
April 26, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29691906/peri-mitral-ventriculoatrial-fistula-after-blunt-thoracic-trauma
#8
Mozhgan Parsaee, Sedigheh Saedi, Roghieh Porkia
Blunt trauma to the chest can damage any thoracic organ. Heart valve damage and particularly mitral apparatus occurs relatively rare, and the patients are expected to become acutely symptomatic. However, in patients with multiple traumas, other dominant severe damages tend to draw away the attention of the physicians resulting in neglect of less salient heart injuries. Here, we present a patient with history of blunt chest trauma and incidental finding of posttraumatic severe mitral regurgitation.
April 24, 2018: Echocardiography
https://www.readbyqxmd.com/read/29687275/pneumomediastinum-and-pneumopericardium-following-blunt-thoracic-trauma-much-ado-about-nothing
#9
David James Jackson Muckart, Timothy Craig Hardcastle, David Lee Skinner
PURPOSE: Pneumomediastinum is the hallmark of intrathoracic aerodigestive trauma, but rare following blunt injury. AIM: review of blunt thoracic trauma (BTC) for the incidence and outcome of patients with pneumomediastinum or pneumopericardium (PM/PC) on Computerised Tomographic scanning. METHODS: Admissions to the level I trauma ICU at IALCH, Durban, ZA following BTC from April 2007 to March 2014. Patients with Chest-CT-scan were analysed...
April 23, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29679240/a-case-of-tension-faecopneumothorax-after-delayed-diagnosis-of-traumatic-diaphragmatic-hernia
#10
Tien Yew Chern, Allan Kwok, Soni Putnis
BACKGROUND: Traumatic diaphragmatic injuries from blunt or penetrating trauma are difficult to detect in the acute setting and, if missed, can result in significant morbidity and mortality in the future. We present a case demonstrating the natural progression of this resulting in faecopneumothorax, which is a rare but serious presentation. CASE PRESENTATION: A 22-year-old young man presented with left upper quadrant and chest pain, nausea, vomiting, and intermittent obstipation with a background of previous lower chest wall stabbings...
April 20, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29668810/predictors-of-chest-drainage-complications-in-trauma-patients
#11
Cecília Araújo Mendes, Elcio Shiyoiti Hirano
OBJECTIVE: to identify predictors of chest drainage complications in trauma patients attended at a University Hospital. METHODS: we conducted a retrospective study of 68 patients submitted to thoracic drainage after trauma, in a one-year period. We analyzed gender, age, trauma mechanism, trauma indices, thoracic and associated lesions, environment in which the procedure was performed, drainage time, experience of the performer, complications and evolution. RESULTS: the mean age of the patients was 35 years and the male gender was the most prevalent (89%)...
2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29668565/the-effects-of-genetic-3-mercaptopyruvate-sulfurtransferase-deficiency-in-murine-traumatic-hemorrhagic-shock
#12
Michael Gröger, Martin Wepler, Ulrich Wachter, Tamara Merz, Oscar McCook, Sandra Kress, Britta Lukaschewski, Sebastian Hafner, Markus Huber-Lang, Enrico Calzia, Michael Georgieff, Noriyuki Nagahara, Csaba Szabó, Peter Radermacher, Clair Hartmann
INTRODUCTION: Hemorrhagic shock is a major cause of death after trauma. An additional blunt chest trauma independently contributes to mortality upon the development of an acute lung injury (ALI) by aggravating pathophysiological consequences of hemorrhagic shock. The maintenance of hydrogen sulfide availability is known to play an important role during hemorrhage and ALI. We therefore tested the impact of a genetic 3-mercaptopyruvate sulfurtransferase mutation (Δ3-MST) in a resuscitated murine model of traumatic-hemorrhagic shock...
April 17, 2018: Shock
https://www.readbyqxmd.com/read/29659473/external-validation-of-a-5-variable-clinical-prediction-rule-for-identifying-children-at-very-low-risk-for-intra-abdominal-injury-following-blunt-abdominal-trauma
#13
Chase A Arbra, Adam M Vogel, Leah Plumblee, Jingwen Zhang, Patrick D Mauldin, Melvin S Dassinger, Robert T Russell, Martin L Blakely, Christian J Streck
BACKGROUND: A clinical prediction rule was previously developed by the Pediatric Surgery Research Collaborative (PedSRC) to identify patients at very low risk for intra-abdominal injury (IAI) and intra-abdominal injury receiving an acute intervention (IAI-I) who could safely avoid abdominal computed tomography (CT) scans following blunt abdominal trauma (BAT). Our objective was to externally validate the rule. METHODS: The public use dataset was obtained from the Pediatric Emergency Care Applied Research Network (PECARN) Intra-abdominal Injury Study...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29657729/risk-factors-for-prolonged-mechanical-ventilation-in-patients-with-severe-multiple-injuries-and-blunt-chest-trauma-a-single-center-retrospective-case-control-study
#14
Yasuyuki Okabe
Aim: Blunt chest trauma is common and is associated with morbidity and mortality in patients with multiple injuries, frequently requiring invasive mechanical ventilation. The aim of this study was to elucidate risk factors for prolonged mechanical ventilation (PMV). Methods: Consecutive adult patients with multiple severe injuries and blunt chest trauma who treated in Chiba Emergency Medical Center (Chiba, Japan) between January 2008 and December 2015 were enrolled in this retrospective chart-review study...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29655592/development-of-a-blunt-chest-injury-care-bundle-an-integrative-review
#15
REVIEW
Sarah Kourouche, Thomas Buckley, Belinda Munroe, Kate Curtis
BACKGROUND: Blunt chest injuries (BCI) are associated with high rates of morbidity and mortality. There are many interventions for BCI which may be able to be combined as a care bundle for improved and more consistent outcomes. OBJECTIVE: To review and integrate the BCI management interventions to inform the development of a BCI care bundle. METHODS: A structured search of the literature was conducted to identify studies evaluating interventions for patients with BCI...
April 7, 2018: Injury
https://www.readbyqxmd.com/read/29644294/isolated-right-atrial-appendage-rupture-following-blunt-chest-trauma
#16
Rakesh Hegde, Nathan Lafayette, Michael Sywak, Gregory Ricketts, Jorge Otero, Scott Kurtzman, Zhongqiu Zhang
Background: Right sided tears or rupture are the most common injury to the heart after blunt chest trauma. The majority of these injuries are to the thin walled atrium. Reports of localized right atrial appendage rupture are rare. The classical features of Beck's triad are unreliable in the trauma bay. With the advent of EFAST (Focused assessment with sonography for trauma extended to thorax), Beck's triad should be considered but not used as the primary clinical tool for diagnosis of cardiac tamponade [1]...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29644263/treatment-for-unstable-pulmonary-sequestration-injury-in-patient-with-severe-blunt-trauma-a-case-report
#17
Sakiko Hiraki, Yohei Okada, Yusuke Arai, Wataru Ishii, Ryoji Iiduka
Case: Pulmonary sequestration is a congenital malformation characterized by nonfunctioning tissue not communicating with the tracheobronchial tree. As the blood pressure in the artery feeding the sequestrated lung tissue is higher than that in the normal pulmonary artery, the risk of massive hemorrhage in pulmonary sequestration is high. We herein present the first case of a severe blunt trauma patient with unstable pulmonary sequestration injury. Outcome and conclusion: The mechanism of pulmonary sequestration injury is vastly different than that of injury to normal lung...
August 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29618191/delayed-massive-hemothorax-requiring-surgery-after-blunt-thoracic-trauma-over-a-5-year-period-complicating-rib-fracture-with-sharp-edge-associated-with-diaphragm-injury
#18
Sung Wook Chang, Kyoung Min Ryu, Jae-Wook Ryu
Delayed massive hemothorax requiring surgery is relatively uncommon and can potentially be life-threatening. Here, we aimed to describe the nature and cause of delayed massive hemothorax requiring immediate surgery. Over 5 years, 1,278 consecutive patients were admitted after blunt trauma. Delayed hemothorax is defined as presenting with a follow-up chest radiograph and computed tomography showing blunting or effusion. A massive hemothorax is defined as blood drainage >1,500 mL after closed thoracostomy and continuous bleeding at 200 mL/hr for at least four hours...
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29613957/health-care-utilization-and-the-cost-of-post-traumatic-ards-care
#19
Anamaria J Robles, Lucy Z Kornblith, Carolyn M Hendrickson, Benjamin M Howard, Amanda S Conroy, Farzad Moazed, Carolyn S Calfee, Mitchell J Cohen, Rachael A Callcut
BACKGROUND: Post-traumatic acute respiratory distress syndrome (ARDS) is associated with prolonged mechanical ventilation and longer hospitalizations. The relationship between post-traumatic ARDS severity and financial burden has not been previously studied. We hypothesized that increasing severity is associated with incrementally higher health care costs. METHODS: Adults arriving as the highest level of trauma activation were enrolled in an ongoing prospective cohort study...
April 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29581683/an-analysis-of-presentation-pattern-and-outcome-of-chest-trauma-patients-at-an-urban-level-1-trauma-center
#20
Rajasekhar Narayanan, Subodh Kumar, Amit Gupta, Virinder Kumar Bansal, Sushma Sagar, Maneesh Singhal, Biplab Mishra, Sanjeev Bhoi, Babita Gupta, Shivanand Gamangatti, Adarsh Kumar, Mahesh Chandra Misra
Chest trauma is an important public health problem accounting for a substantial proportion of all trauma admissions and deaths. It directly account for 20-25 % of deaths due to trauma. Therefore, this study was conducted to analyze the presentation, patterns, and outcome of chest trauma in a level-1 urban trauma center. It was a prospective observational study of all patients presented with chest trauma to an urban level 1-trauma center over a period of 3 years. Demographic profile, mechanism of injury, injury severity scores (ISS), associated injuries, hospital stay, etc...
February 2018: Indian Journal of Surgery
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