Cardiac and Pulmonary Injury

Velmahos, George C.; Butt, Muhammad U.

doi:10.1007/s00068-008-8099-4

Cited by 10 publications

(15 citation statements)

References 61 publications

(71 reference statements)

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“…7,9,18,19 A subxiphoid relief puncture of the pericardium is rarely successful, because the pericardial blood has coagulated; it can even produce a lesion of the heart. 7,9,11,18,[20][21][22] In addition to volume substitution, [12][13][14][15]22 oral intubation 13,21 is needed to delay the cardiac decompensation. Intubation also enables the administration of a general anesthetic agent, which can suppress the pain-related tachycardia, in this manner preventing more rapid "empty pumping" of the heart.…”

Section: Discussionmentioning

confidence: 99%

“…The restlessness caused by pain can move the intracardiac foreign body in such a way as to enlarge the myocardial defect. 6 Because simultaneous injury of the lung often occurs, 11,13,21 the insertion of a chest tube is indicated at the least suspicion of a pulmonary lesion, especially if helicopter transport has to be arranged. Many patients die of tension pneumothorax, before the penetrating heart injury can kill them.…”

Section: Discussionmentioning

confidence: 99%

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Penetrating Nail-Gun Injury of the Heart Managed by Adenosine-Induced Asystole in the Absence of a Heart-Lung Machine

Rupprecht¹,

Ghidau²

2014

Texas Heart Institute Journal

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During his work, an 18-year-old carpenter-in-training overbalanced and shot himself in the left median thorax with a nail gun. The patient was delivered to our thoracic surgery unit with a tentative diagnosis of penetrating lung trauma. An emergent computed tomogram showed a heart-penetrating nail injury. The patient was taken to the operating room, where he underwent emergency surgery that included sternotomy, pericardiotomy, extraction of the nail, and trauma treatment of the heart injury. The surgery was performed in a unit without a heart-lung machine. For that reason, asystole was chemically induced by the intravenous administration of adenosine. The surgery was successful, and the patient was discharged from the hospital on the 10th postoperative day. In cases of penetrating injuries of the heart, especially those with a foreign body retained in situ, we believe that the intravenous administration of adenosine is an elegant solution for the rapid provocation of asystole. In contrast to other methods, adenosine-induced asystole enables relatively safe myocardial manipulation in the absence of a cardiac surgical unit and a heart-lung machine.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Penetrating Nail-Gun Injury of the Heart Managed by Adenosine-Induced Asystole in the Absence of a Heart-Lung Machine

Rupprecht¹,

Ghidau²

2014

Texas Heart Institute Journal

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“…In our current case the injection of adenosine did not lead to the desired reaction. In special cardiac injury patterns the bolus-injection of adenosine is a therapeutic option [26][27][28][29]. Alternatively, a Forgatyor a Foley-catheter can be placed for temporary defect occlusion [30][31][32][33][34].…”

Section: Emergency Surgerymentioning

confidence: 99%

“…To exclude intracardial lesions (perimembranous interventricular septum anomaly, heart valve vitium), and to decide about a secondary transfer in a cardio-surgical centre [71], a transthoracic or transesophageal echocardiography should be performed [3,19,28,45,51]. When insufficient oxygenation or hypercapnic respiratory insufficiency is detected, early extracorporeal oxygenation procedures, like ECMO (extracorporeal membrane oxygenation) or ILA (intervential lung assist) should be performed [60,72].…”

Section: Further Measuresmentioning

confidence: 99%

Delayed Cardiac Rupture Induced by Traumatic Myocardial Infarction: Consequence of a 45-Magnum Blast Injury; A Comprehensive Case Review

Rupprecht¹,

Gaab²

2018

BEAT

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A penetrating chest trauma, a myocardial contusion or a myocardial infarction can lead to a cardiac rupture, which is linked to an extreme high death rate. Only few cases with delayed perforation of the myocardium have been reported in literature. We report about a penetrating gunshot injury, which led to a myocardial contusion with secondary delayed rupture of the left ventricle and the left inferior lobe of the lung. The leakage of the lesion in the left ventricle could be sealed sufficiently with fibrin-coated collagen fleeces after adapting stitches with Prolene 2-0. For additional stabilization of the vulnerable myocardium area, a bovine patch has been placed on the damaged ventricle. Fibrin fleeces are used successfully in cardiac surgery, as in our case, to seal the leakage of the lesion in the left ventricle. The implantation of a bovine patch in the pericardium could prevent a cardiac compartment syndrome with a fatal pericardial tamponade. To prohibit a thoracic compartment syndrome a modified Bogota bag could be sewed in for temporarily closure of the chest. In most cases penetrating cardiac injuries can be treated without heart-lung-machines. An immediate transfer to a cardio-surgical center is, due to the acute situation, not possible. If a surgeon with thoraco-surgical expertise is present a transfer is not absolutely necessary,

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“…Cardiopulmonary injuries present a special challenge, both in diagnosis and treatment [4]. Any delay can mean death and ideal treatment requires optimal interdisciplinary cooperation.…”

mentioning

confidence: 99%

Focus on Solid Organ Injury

Uranues¹

2008

Eur J Trauma Emerg Surg

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Cardiac and Pulmonary Injury

Cited by 10 publications

References 61 publications

Penetrating Nail-Gun Injury of the Heart Managed by Adenosine-Induced Asystole in the Absence of a Heart-Lung Machine

Penetrating Nail-Gun Injury of the Heart Managed by Adenosine-Induced Asystole in the Absence of a Heart-Lung Machine

Delayed Cardiac Rupture Induced by Traumatic Myocardial Infarction: Consequence of a 45-Magnum Blast Injury; A Comprehensive Case Review

Focus on Solid Organ Injury

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