Chest injuries – what is new?

Keel, Marius; Meier, Christoph

doi:10.1097/mcc.0b013e3282f1fe71

Cited by 60 publications

(28 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…(7) However, the case reported here differs from prior reports in several important ways. This patient had refractory hypoxemia from several injury mechanisms (pulmonary contusion, bilateral extensive pneumothorax and an unstable chest wall) and had a PaO 2 /FiO 2 ratio of 56.…”

Section: Discussioncontrasting

confidence: 55%

Uso de suporte hemodinâmico e respiratório por meio de oxigenação extracorpórea por membrana (ECMO) venoarterial em um paciente politraumatizado

Bassi¹,

Azevedo²,

Costa³

et al. 2011

Rev. bras. ter. intensiva

View full text Add to dashboard Cite

Uso de suporte hemodinâmico e respiratório por meio de oxigenação extracorpórea por membrana (ECMO) venoarterial em um paciente politraumatizado INTRODUCTIONThe use of extracorporeal membrane oxygenation (ECMO) as respiratory support has been widely acknowledged as a rescue technique for refractory hypoxemia in H1N1-infected patients.(1) Recently, our institution adopted the use of ECMO in the intensive care unit (ICU) for selected refractory cardiopulmonary dysfunction cases.In the venoarterial modality, venous blood is oxygenated and pumped back into the arterial system, providing total/nearly total cardiorespiratory support. This method is mostly used in patients who are difficult to wean from cardiopulmonary bypass following acute myocardial infarction or in cases of refractory cardiac arrest. (2) Few investigators have reported the use of ECMO for simultaneous posttraumatic cardiac and pulmonary dysfunctions. (3,4) In this article, we report the case of a 48-year-old male patient with cardiogenic shock and hypoxemia due to cardiac and pulmonary contusions, who was successfully supported by venoarterial ECMO until cardiorespiratory recovery. CASE REPORTA 48-year-old male patient, with no previous comorbidities, was brought to the emergency service of Hospital das Clínicas after a serious traffic accident (automobile versus motorcycle). The patient was a motorcycle rider who was not wearing a helmet. At the accident site, he had an oxygen saturation of ABSTRACTThere are few reports in the literature regarding the use of venoarterial extracorporeal membrane oxygenation (ECMO) for double-dysfunction from both heart and lung contusions in polytrauma patients. This article reports a 48-year-old patient admitted after a traffic accident. He rapidly progressed to shock with low cardiac output due to myocardial contusion and refractory hypoxemia due to pulmonary contusion, an unstable chest wall and bilateral pneumothorax. ECMO was an effective rescue procedure in this dramatic situation and was successfully discontinued on the fourth day after the trauma. The patient also developed an extensive brain infarction and eventually died on the seventh day after admission. Conflicts of interest:The ECMO membranes were donated by Maquet Cardiopulmonary.

show abstract

Section: Discussioncontrasting

confidence: 55%

Uso de suporte hemodinâmico e respiratório por meio de oxigenação extracorpórea por membrana (ECMO) venoarterial em um paciente politraumatizado

Bassi¹,

Azevedo²,

Costa³

et al. 2011

Rev. bras. ter. intensiva

View full text Add to dashboard Cite

show abstract

“…Thoracic trauma can crucially deteriorate the outcome of trauma patients [39,40]. Pulmonary complications including pneumonia, ARDS and other can detrimentally influence the outcome after trauma [1,5,[41][42][43].…”

Section: Discussionmentioning

confidence: 99%

Leukotriene B4 indicates lung injury and on-going inflammatory changes after severe trauma in a porcine long-term model

Störmann

Auner

Schimunek

et al. 2017

Prostaglandins, Leukotrienes and Essential Fatty Acids

View full text Add to dashboard Cite

A B S T R A C TBackground: Recognizing patients at risk for pulmonary complications (PC) is of high clinical relevance. Migration of polymorphonuclear leukocytes (PMN) to inflammatory sites plays an important role in PC, and is tightly regulated by specific chemokines including interleukin (IL)−8 and other mediators such as leukotriene (LT)B4. Previously, we have reported that LTB4 indicated early patients at risk for PC after trauma. Here, the relevance of LTB4 to indicating lung integrity in a newly established long-term porcine severe trauma model (polytrauma, PT) was explored. Methods: Twelve pigs (3 months old, 30 ± 5 kg) underwent PT including standardized femur fracture, lung contusion, liver laceration, hemorrhagic shock, subsequent resuscitation and surgical fracture fixation. Six animals served as controls (sham). After 72 h lung damage and inflammatory changes were assessed. LTB4 was determined in plasma before the experiment, immediately after trauma, and after 2, 4, 24 or 72 h. Bronchoalveolar lavage (BAL)-fluid was collected prior and after the experiment. Results: Lung injury, local gene expression of IL-8, IL-1β, IL-10, IL-18 and PMN-infiltration into lungs increased significantly in PT compared with sham. Systemic LTB4 increased markedly in both groups 4 h after trauma. Compared with declined plasma LTB4 levels in sham, LTB4 increased further in PT after 72 h. Similar increase was observed in BAL-fluid after PT. Conclusions: In a severe trauma model, sustained changes in terms of lung injury and inflammation are determined at day 3 post-trauma. Specifically, increased LTB4 in this porcine long-term model indicated a rapid inflammatory alteration both locally and systemically. The results support the concept of LTB4 as a biomarker for PC after severe trauma and lung contusion.

show abstract

“…Secondary ischemic cardiac injury describes myocardial ischemia with myocyte injury in the absence of atherosclerotic plaque rupture and due to increased myocardial oxygen demand that outstrips myocardial oxygen supply. Nonischemic cardiac injury describes cTn release caused by direct damage to the myocardium, including blunt trauma (24), penetrating trauma (25), myocarditis (26), or drug and toxin-induced cardiotoxicity (27). At the present time, the release of cTn by healthy individuals after exercise cannot be explained by any of these pathophysiologic scenarios.…”

Section: Troponin Biochemistry and Routine Clinical Usementioning

confidence: 98%

Exercise-Induced Cardiac Troponin Elevation

Shave

Baggish

George

et al. 2010

Journal of the American College of Cardiology

359

138

View full text Add to dashboard Cite

Regular physical exercise is recommended for the primary prevention of cardiovascular disease. Although the high prevalence of physical inactivity remains a formidable public health issue, participation in exercise programs and recreational sporting events, such as marathons and triathlons, is on the rise. Although regular exercise training reduces cardiovascular disease risk, recent studies have documented elevations in cardiac troponin (cTn) consistent with cardiac damage after bouts of exercise in apparently healthy individuals. At present, the prevalence, mechanism(s), and clinical significance of exercise-induced cTn release remains incompletely understood. This paper will review the biochemistry, prevalence, potential mechanisms, and management of patients with exercise-induced cTn elevations.

show abstract

Chest injuries – what is new?

Cited by 60 publications

References 34 publications

Uso de suporte hemodinâmico e respiratório por meio de oxigenação extracorpórea por membrana (ECMO) venoarterial em um paciente politraumatizado

Uso de suporte hemodinâmico e respiratório por meio de oxigenação extracorpórea por membrana (ECMO) venoarterial em um paciente politraumatizado

Leukotriene B4 indicates lung injury and on-going inflammatory changes after severe trauma in a porcine long-term model

Exercise-Induced Cardiac Troponin Elevation

Contact Info

Product

Resources

About