Emergency thoracotomies: Two center study
Introduction and Aim: Emergency thoracotomy is performed either immediately at the scene of injury, in the emergency department or in the operating room. It aims to evacuate the pericardial tamponade, control the haemorrhage, to ease the open cardiac massage and to cross-clamp the descending thoraci...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2013-01-01
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| Series: | Journal of Emergencies, Trauma and Shock |
| Subjects: | |
| Online Access: | http://www.onlinejets.org/article.asp?issn=0974-2700;year=2013;volume=6;issue=1;spage=11;epage=15;aulast=Sersar |
| _version_ | 1828861217274331136 |
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| author | Sameh Ibrahim Sersar Mohammed Adel AlAnwar |
| author_facet | Sameh Ibrahim Sersar Mohammed Adel AlAnwar |
| author_sort | Sameh Ibrahim Sersar |
| collection | DOAJ |
| description | Introduction and Aim: Emergency thoracotomy is performed either immediately at the scene of injury, in the emergency department or in the operating room. It aims to evacuate the pericardial tamponade, control the haemorrhage, to ease the open cardiac massage and to cross-clamp the descending thoracic aorta to redistribute blood flow and maybe to limit sub-diaphragmatic haemorrhage, bleeding and iatrogenic injury are the common risk factors. We aimed to review our experience in the field of emergency thoracotomies, identify the predictors of death, analyze the early results, detect the risk factors and asses the mortalities and their risk factors. Patients and Methods: Our hospital records of 197 patients who underwent emergency thoracotomy were reviewed. We retrospectively analyzed a piece of the extensive experience of the Mansoura University Hospitals and Mansoura Emergency Hospital; Egypt and Saudi German Hospitals; Jeddah in the last 12 years in the management of trauma cases for whom emergency thoracotomy. The aim was to analyse the early results of such cases and to detect the risk factors of dismal prognosis. Results: Our series included 197 cases of emergency thoractomies in Mansoura; Egypt and SGH; Jeddah; KSA in the last 12 years. The mean age of the victims was 28 years and ranged between 5 and 62 years. Of the 197 patients with emergency thoracotomy, the indications were both penetrating and blunt chest trauma, iatrogenic and postoperative hemodynamito a surgical cause. The commonest indication was stab heart followed by traumatic diaphragmatic ruptures. Conclusion: The results of emergency thoracotomy in our series were cooping with the results of other reports, mainly due to our aggressive measures to achieve rapid stabilization of the hemodynamic condition. We emphasize the importance of emergency medicine education programs on rapid diagnosis of traumatic injuries with early intervention, and adequate hemodynamic and respiratory support. Emergency thoracotomy has an important role in emergency big volume hospitals and can save a lot of lives. Outcome can be improved by increasing the learning curve and the integrated cooperation of the emergency and surgical teams. |
| first_indexed | 2024-12-13T02:56:24Z |
| format | Article |
| id | doaj.art-735749ae1236445e81593c771eeb2684 |
| institution | Directory Open Access Journal |
| issn | 0974-2700 |
| language | English |
| last_indexed | 2024-12-13T02:56:24Z |
| publishDate | 2013-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Emergencies, Trauma and Shock |
| spelling | doaj.art-735749ae1236445e81593c771eeb26842022-12-22T00:01:56ZengWolters Kluwer Medknow PublicationsJournal of Emergencies, Trauma and Shock0974-27002013-01-0161111510.4103/0974-2700.106319Emergency thoracotomies: Two center studySameh Ibrahim SersarMohammed Adel AlAnwarIntroduction and Aim: Emergency thoracotomy is performed either immediately at the scene of injury, in the emergency department or in the operating room. It aims to evacuate the pericardial tamponade, control the haemorrhage, to ease the open cardiac massage and to cross-clamp the descending thoracic aorta to redistribute blood flow and maybe to limit sub-diaphragmatic haemorrhage, bleeding and iatrogenic injury are the common risk factors. We aimed to review our experience in the field of emergency thoracotomies, identify the predictors of death, analyze the early results, detect the risk factors and asses the mortalities and their risk factors. Patients and Methods: Our hospital records of 197 patients who underwent emergency thoracotomy were reviewed. We retrospectively analyzed a piece of the extensive experience of the Mansoura University Hospitals and Mansoura Emergency Hospital; Egypt and Saudi German Hospitals; Jeddah in the last 12 years in the management of trauma cases for whom emergency thoracotomy. The aim was to analyse the early results of such cases and to detect the risk factors of dismal prognosis. Results: Our series included 197 cases of emergency thoractomies in Mansoura; Egypt and SGH; Jeddah; KSA in the last 12 years. The mean age of the victims was 28 years and ranged between 5 and 62 years. Of the 197 patients with emergency thoracotomy, the indications were both penetrating and blunt chest trauma, iatrogenic and postoperative hemodynamito a surgical cause. The commonest indication was stab heart followed by traumatic diaphragmatic ruptures. Conclusion: The results of emergency thoracotomy in our series were cooping with the results of other reports, mainly due to our aggressive measures to achieve rapid stabilization of the hemodynamic condition. We emphasize the importance of emergency medicine education programs on rapid diagnosis of traumatic injuries with early intervention, and adequate hemodynamic and respiratory support. Emergency thoracotomy has an important role in emergency big volume hospitals and can save a lot of lives. Outcome can be improved by increasing the learning curve and the integrated cooperation of the emergency and surgical teams.http://www.onlinejets.org/article.asp?issn=0974-2700;year=2013;volume=6;issue=1;spage=11;epage=15;aulast=SersarEmergency thoracotomy; traumapost-operative |
| spellingShingle | Sameh Ibrahim Sersar Mohammed Adel AlAnwar Emergency thoracotomies: Two center study Journal of Emergencies, Trauma and Shock Emergency thoracotomy; trauma post-operative |
| title | Emergency thoracotomies: Two center study |
| title_full | Emergency thoracotomies: Two center study |
| title_fullStr | Emergency thoracotomies: Two center study |
| title_full_unstemmed | Emergency thoracotomies: Two center study |
| title_short | Emergency thoracotomies: Two center study |
| title_sort | emergency thoracotomies two center study |
| topic | Emergency thoracotomy; trauma post-operative |
| url | http://www.onlinejets.org/article.asp?issn=0974-2700;year=2013;volume=6;issue=1;spage=11;epage=15;aulast=Sersar |
| work_keys_str_mv | AT samehibrahimsersar emergencythoracotomiestwocenterstudy AT mohammedadelalanwar emergencythoracotomiestwocenterstudy |