Use of CT for Diagnosis of Traumatic Rupture of the Thoracic Aorta

Tomiak, Myrosia M.; Rosenblum, Jordan D.; Messersmith, Richard N.; Zarins, Christopher K.

doi:10.1007/bf02001006

Cited by 20 publications

(2 citation statements)

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“…Dado que el paciente politraumatizado es frecuentemente derivado al servicio de radiología para la realización de una tomografía computarizada para la evaluación de un posible TEC y/o trauma abdominal, ésta puede ser usada también para la evaluación de la aorta torácica. En un inicio fue catalogada como un mal método por presentar, en relación con la aortografía, una sensibilidad de sólo 55% a 83% y una especificidad de 23% a 65% [62], [63], con 17% de falsos negativos y 39% de falsos positivos [64]. Sin embargo, el desarrollo tecnológico de la tomografía computarizada ha permitido mejorar su rendimiento [16] a una positividad de 74% (23% equívoca, 3% negativa) y un valor predictivo negativo de 100% [65].…”

Section: Lesiones Vascularesunclassified

Traumatismo torácico y anestesia

Garrido¹

2021

Rev. chil. anest.

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The thoracic trauma patient is generally of young, working age, and is often affected by multiple trauma. In its preoperative management, the functional repercussions secondary to thoracic injuries (pulmonary contusion, myocardial contusion, flail chest, etc.) should be evaluated. These become more important when anesthesia must be administered for surgical resolution of neurological, abdominal or limb injuries, and especially, when emergency thoracic surgery must be performed. Only 15% of patients with chest trauma require surgery. In emergency situations, regional techniques are limited to be a part of the postoperative analgesia or they are indicated in case of extensive nonsurgical parietal lesions. These are patients that have a full stomach in whom, in many cases, a chest drain must be installed prior to or during anesthetic induction. Induction agents that produce less hemodynamic compromise and maintenance with halogenated gases are suggested. Double-lumen endobronchial tubes are the standard method for providing lung isolation. Intraoperative mechanical ventilation should be provided considering the concepts of pulmonary protection taken from intensive medicine. Good postoperative analgesia facilitates respiratory physiotherapy, prevents deterioration of lung function, and allows early ambulation, helping altogether to reduce the incidence of pulmonary and thromboembolic complications.

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