Blunt cardiac and pericardial rupture without cardiac herniation: a diagnostic challenge

Lee, Jun-Wan; Hwang, Jiwon; Kim, Kil-Dong; Choi, Jin Ho

doi:10.1111/j.1445-2197.2011.05768.x

Cited by 2 publications

(1 citation statement)

References 2 publications

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“…In addition to above mentioned advantages, if an intensivist is a surgeon, he/she can be actively involved in the initial resuscitation phase or operative phase in a emergency department when intervention is critically important or needed emergently, as we described previosly 15. Furthermore, Tinti, et al16 demonstrated that transition to an intensivist model led to improved resident job satisfaction.…”

Section: Discussionmentioning

confidence: 76%

Feasibility and Early Outcomes of Intensivist-Led Critical Care after Major Trauma in the Korean ICU

2013

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PurposeSubstantial evidence supports the benefits of an intensivist model of critical care delivery. However, currently, this mode of critical care delivery has not been widely adopted in Korea. We hypothesized that intensivist-led critical care is feasible and would improve ICU mortality after major trauma.Materials and MethodsA trauma registry from May 2009 to April 2011 was reviewed retrospectively. We evaluated the relationship between modes of ICU care (open vs. intensivist) and in-hospital mortality following severe injury [Injury Severity Score (ISS) >15]. An intensivist-model was defined as ICU care delivered by a board-certified physician who had no other clinical responsibilities outside the ICU and who is primarily available to the critically ill or injured patients. ISS and Revised Trauma Score were used as measure of injury severity. The Trauma and Injury Severity Score methodology was used to calculate each individual patient's probability of survival.ResultsOf the 251 patients, 57 patients were treated by an intensivist [intensivist group (IG)] while 194 patients were not [non-intensivist group (NIG)]. The ISS of IG was significantly higher than that for NIG (26.5 vs. 22.3, p=0.023). The hospital mortality rate for IG was significantly lower than that for NIG (15.8% and 27.8%, p<0.001).ConclusionThe intensivist model of critical care is feasible, and there is room for improvement in the care of major trauma patients. Although trauma systems take time to mature, future studies are needed to evaluate the best model of critical care delivery for severely injured patients in Korea.

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Section: Discussionmentioning

confidence: 76%

Feasibility and Early Outcomes of Intensivist-Led Critical Care after Major Trauma in the Korean ICU

2013

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Thoracoscopic diagnosis of traumatic pericardial rupture with cardiac hernia: A case report

Wu¹,

He²,

Lu³

2021

WJCC

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BACKGROUND Pericardial rupture caused by blunt chest trauma is rare in clinical practice. Because of its atypical clinical symptoms, and because surgeons are often unfamiliar with the clinical and radiological manifestations of the injury, preoperative diagnosis is difficult; it is easily misdiagnosed and causes serious consequences. CASE SUMMARY A 60-year-old man, previously healthy, was transported to the emergency room after falling from a great height. Upon arrival, his vital signs were stable. Electrocardiography and echocardiography were performed, and there was no sign of cardiac injury or ischemia. Chest and abdomen computerized tomography revealed pneumopericardium, hemopneumothorax, lung contusion, multiple rib fractures on the right side (Figure 1 ), and right scapula and clavicle fractures. He was admitted to the inpatient department for further observation after tube thoracostomy. The next day, the patient suddenly experienced rapid arrhythmia (the ventricular rate reached 150-180 beats/min) when turning onto his right side, accompanied by a blood pressure drop to 70/45 mm Hg and a chief complaint of palpitation. Thoracoscopy was performed urgently, and a large vertical tear (8 cm × 6 cm) was found in the pericardium. The defect was successfully repaired using a heart Dacron patch. His postoperative condition was uneventful without any fluctuations in vital signs, and he was transferred to the orthopedics department for further surgery on postoperative day 8. CONCLUSION Although the possibility of pericardial rupture combined with cardiac hernia is extremely low, it is one of the causes of cardiogenic shock following blunt trauma. Therefore, clinicians need to be more familiar with its characteristic manifestations and maintain a high degree of vigilance against such injuries to avoid disastrous consequences.

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Blunt cardiac and pericardial rupture without cardiac herniation: a diagnostic challenge

Cited by 2 publications

References 2 publications

Feasibility and Early Outcomes of Intensivist-Led Critical Care after Major Trauma in the Korean ICU

Feasibility and Early Outcomes of Intensivist-Led Critical Care after Major Trauma in the Korean ICU

Thoracoscopic diagnosis of traumatic pericardial rupture with cardiac hernia: A case report

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