Blunt Trauma to the Thorax - Mechanism of Vascular Injuries

Roberts, Verne L.; Moffat, Robert C.; Berkas, Ernest M.

doi:10.4271/650950

Cited by 13 publications

(3 citation statements)

References 4 publications

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“…Researchers such as Stapp (1965)and Taylor (1963) report that pressure is the major factor. However, cardiac rupture has been produced experimentally in animals with the blood volume entirely removed, strongly suggesting that other factors are involved (Roberts et al, 1965). Lasky et al (1968), studying adult humans involved in steering wheel impacts, believes that aortic laceration occurs at the weakest and narrowest point of the aortic arch, and that this anatomical fact is of biodynamic significance.…”

Section: Infant 4 Year Old Adultmentioning

confidence: 99%

Infants and children in the adult world of automobile safety design: Pediatric and anatomical considerations for design of child restraints

Burdi

Huelke

Snyder

et al. 1969

Journal of Biomechanics

139

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The infant and child differ structurally from the adult in a number of ways which are critical to the design for protection against impact forces and for adequate occupant restraint systems. The purpose of this paper is to bring together a profile of the anatomy, anthropomctry, growth, and development of the infant and child. Age differences related to the proper design of child restraint systems are emphasized. Problems discussed include child-adult structural differences, center of gravity of the body, the head mass in relation to the neck and general body proportions, positions of key organs, and biomechanical properties of tissues.

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Section: Infant 4 Year Old Adultmentioning

confidence: 99%

Infants and children in the adult world of automobile safety design: Pediatric and anatomical considerations for design of child restraints

Burdi

Huelke

Snyder

et al. 1969

Journal of Biomechanics

139

View full text Add to dashboard Cite

show abstract

“…Various thoracic impacts have been reported to cause traumatic aortic rupture (Mulder,1980; Symbas et al, 1998; Frankyn et al, 2003; Conroy et al,2007). This has led to many theories for the mechanism of aortic rupture (Parmley et al,1958; Zehnder,1960,1974; Lundevall1964; Roberts et al,1966,1967; Rittenhouse et al,1969; Sutorious et al,1973; Gotze et al,1980; Stark1984; Shkrum et al,1999; Schmoker et al,2008). The most widely held mechanism of aortic rupture is that the descending aorta remains relatively fixed at the posterior thoracic wall by the intercostal arteries while the heart and aortic arch are mobile (Roberts et al,1967; Sevitt,1977; Gotze et al,1980).…”

Section: Introductionmentioning

confidence: 99%

Chest impact experiments aimed at producing aortic rupture

Viano¹

2011

Clinical Anatomy

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There are a number of proposed mechanisms of traumatic aortic rupture. These experiments involved three different chest impacts that may be associated with aortic rupture. Eleven unembalmed cadavers were repressurized and impacted by a 24-34 kg mass at 8.6-14.9 m/sec. Three impact orientations were studied with the torso axis: (1) 30-45° up from horizontal and impact 28-45° clockwise of the midsagittal axis, (2) 105-130° up from horizontal and impact 15° counterclockwise, and (3) 75° up from horizontal and impact 15° counterclockwise. Spinal acceleration was measured at T1, T8, and T12 and chest compression was determined by high-speed video. Detailed autopsy determined injuries. Impact loads averaged 9.65 ± 2.45 kN and resulted in 52.8 ± 5.4% chest compression and 3.53 ± 0.94 m/sec Viscous response. The resultant spinal acceleration was 124.5 ± 105.4 g at T1, 141.3 ± 80.5 g at T8 and 89.3 ± 39.1 g at T12. The severity of impact resulted in multiple rib fractures and severe chest injury averaging AIS = 4.2 ± 1.0. There were four cases of heart laceration and one transection of the ascending aorta 20 mm from the cusp of the aortic valve. The impacts were severe enough that aortic rupture was expected; however, only one occurred. In retrospect, the position of the heart and aorta in the upright cadaver may not have been representative of the position during human injury, thus reducing the incidence of aortic rupture in these experiments.

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“…Early studies hypothesized several individual mechanisms of blunt TAR [5][6][7]. These mechanisms include: a transient rise in arterial blood pressure; inertial loading as the chest is accelerated; and chest deformation as the sternum is displaced posteriorly relative to the spine.…”

Section: Introductionmentioning

confidence: 99%

Pressure waves in the aorta during isolated abdominal belt loading: the magnitude, phasing, and attenuation

Arregui‐Dalmases

Pozo

Stacey

et al. 2011

Proc Inst Mech Eng H

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While rupture of the aorta is a leading cause of sudden death following motor vehicle crashes, the specific mechanism that causes this injury is not currently well understood. Aortic ruptures occurring in the field are likely due to a complex combination of contributing factors such as acceleration, compression of the chest, and increased pressure within the aorta. The objective of the current study was to investigate one of these factors in more detail than has been done previously; specifically, to investigate the in situ intra-aortic pressure generated during isolated belt loading to the abdomen. Ten juvenile swine were subjected to dynamic belt loads applied to the abdomen. Intraaortic pressure was measured at multiple locations to assess the magnitude and propagation of the resulting blood pressure wave. The greatest average peak pressure (113.6 +/- 43.5 kPa) was measured in the abdominal aorta. Pressures measured in the thoracic aorta and aortic arch were 70 per cent and 50 per cent, respectively, that measured in the abdominal aorta. No macroscopic aortic trauma was observed. To the authors' knowledge the present study is the first one to document the presence, propagation, and attenuation of a transient pressure wave in the aorta generated by abdominal belt loading. The superiorly moving wave is sufficient to generate hydrostatic and intimal shear stress in the aorta, possibly contributing to the hypothesized mechanisms of traumatic aortic rupture.

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Blunt Trauma to the Thorax - Mechanism of Vascular Injuries

Cited by 13 publications

References 4 publications

Infants and children in the adult world of automobile safety design: Pediatric and anatomical considerations for design of child restraints

Infants and children in the adult world of automobile safety design: Pediatric and anatomical considerations for design of child restraints

Chest impact experiments aimed at producing aortic rupture

Pressure waves in the aorta during isolated abdominal belt loading: the magnitude, phasing, and attenuation

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