Quantification of traumatic hemomediastinum using transesophageal echocardiography: impact on patient management

Chest
P VignonH Gastinne

Abstract

To determine whether the quantitative evaluation of hemomediastinum using transesophageal echocardiography (TEE) is predictive of the presence of a traumatic disruption of the thoracic aorta (TDA) or its branches in patients who have sustained severe blunt chest trauma. Retrospective study. ICU of a tertiary referral teaching hospital. Forty-one patients sustaining severe blunt chest trauma (32 men, nine women; mean age, 43+/-16 years; mean Injury Severity Score, 39+/-22) who underwent a TEE study were divided into two groups, patients with (group TDA+, n=15) or without (group TDA-, n=26) major vascular injury diagnosed using an alternative method such as aortography, surgery, or necropsy. The control group included 41 age- and sex-matched patients with an unremarkable TEE study performed to rule out an intracardiac source of emboli. The presence of hemomediastinum was quantitatively assessed by measuring the distances between the esophageal scope and anteromedial aortic wall (distance 1), and between the posterolateral aortic wall and left visceral pleura (distance 2) at the level of the aortic isthmus. An observer who was unaware of both medical history and final diagnosis measured the distances. In group TDA+, TEE demonstrat...Continue Reading

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Citations

Nov 16, 2007·Intensive Care Medicine·Caroline Etchecopar-ChevreuilPhilippe Vignon
Jan 8, 2000·The Surgical Clinics of North America·B R BoulangerA Rodriguez
Sep 12, 2003·Journal of Cardiothoracic and Vascular Anesthesia·Toshiya ShigaRyo Ogawa
Aug 13, 2005·Critical Care Medicine·Philippe VignonHervé Gastinne
Feb 15, 2001·Echocardiography·Philip Vignon, Roberto M. Lang
Oct 8, 2008·Cardiovascular Ultrasound·Susanna PriceUNKNOWN World Interactive Network Focused On Critical UltraSound ECHO-ICU Group
Apr 13, 2007·Critical Care : the Official Journal of the Critical Care Forum·Philippe VignonHervé Gastinne
May 19, 2012·Case Reports in Surgery·J M JosseK Khwaja
Sep 22, 2005·Echocardiography·Edmund Kenneth KerutFrederick Helmcke
Jan 25, 2003·Intensive Care Medicine·Vincent FraipontFrançois Damas
Feb 26, 2004·Anesthesia and Analgesia·James P Hofmann, Thomas J Papadimos
Oct 11, 2007·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Bettina MartyLudwig Karl von Segesser

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