Diagnosis and treatment of deep pulmonary laceration with intrathoracic hemorrhage from blunt trauma

The Annals of Thoracic Surgery
N NishiumiHiroshi Inoue

Abstract

Blunt chest trauma resulting in massive hemothorax requires immediate attention. We investigated the diagnostic and prognostic utility of various clinical factors in patients with deep pulmonary laceration caused by blunt chest trauma with a view toward interventional treatment. We reviewed 42 patients with deep pulmonary laceration resulting from blunt chest trauma who were treated between 1988 and 2008. Various clinical factors were compared between survivors and nonsurvivors. Of the 42 patients, 29 (69%) survived. Median (25th, 75th percentile) systolic blood pressure at arrival was 102 (76, 121) mm Hg for survivors and 70 (60, 90) mm Hg for nonsurvivors (p = 0.015). The median heart rate at arrival was 107 (98, 120) beats/min for survivors and 130 (120, 140) beats/min for nonsurvivors (p = 0.014). Respiratory rate, Glasgow Coma Scale score, and arterial blood gas values did not affect prognosis. Blood loss through the chest tube at insertion was 500 (400, 700) mL for survivors and 700 (500, 1000) mL for nonsurvivors (p = 0.147) and within 2 hours of arrival was 850 (590, 1100) mm Hg and 1600 (1400, 2000) mL, respectively (p < 0.001). Blood loss during thoracotomy was 1170 (600, 1790) mL and 3500 (2000, 6690), respectively (...Continue Reading

References

Apr 1, 1993·The Journal of Trauma·H InoueA Shohtsu
Feb 24, 2001·The Annals of Thoracic Surgery·N NishiumiH Inoue
Aug 10, 2002·The Journal of Trauma·Noboru NishiumiHiroshi Inoue
Dec 16, 2003·American Journal of Surgery·Joseph HuhKenneth L Mattox
Jan 18, 2006·Injury·P A HuntW A Owens
Dec 25, 2007·The Annals of Thoracic Surgery·Noboru NishiumiHiroshi Inoue
Jan 28, 2010·The Annals of Thoracic Surgery·Noboru NishiumiHiroshi Inoue

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Citations

Oct 27, 2010·Thoracic Surgery Clinics·Tamas F Molnar
Jan 28, 2010·The Annals of Thoracic Surgery·Cameron Wright
Sep 11, 2014·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Stephan HuberStefan Huber-Wagner
May 20, 2014·Case Reports in Emergency Medicine·Hideki OtaTsubasa Matsuo
Dec 4, 2014·The American Journal of Emergency Medicine·Shokei MatsumotoMitsuhide Kitano
Jan 28, 2010·The Annals of Thoracic Surgery·Noboru NishiumiHiroshi Inoue
May 18, 2020·Chinese Journal of Traumatology = Zhonghua Chuang Shang Za Zhi·Bekir Nihat DogrulSelim Can Peker

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