Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8730025 | Journal of Visceral Surgery | 2017 | 7 Pages |
Abstract
Resuscitation thoracotomy is a rarely performed procedure whose use, in France, remains marginal. It has five specific goals that correspond point-by-point to the causes of traumatic cardiac arrest: decompression of pericardial tamponade, control of cardiac hemorrhage, performance of internal cardiac massage, cross-clamping of the descending thoracic aorta, and control of lung injuries and other intra-thoracic hemorrhage. This approach is part of an overall Damage Control strategy, with a targeted operating time of less than 60Â minutes. It is indicated for patients with cardiac arrest after penetrating thoracic trauma if the duration of cardio-pulmonary ressuscitation (CPR) is <15Â minutes, or <10Â minutes in case of closed trauma, and for patients with refractory shock with systolic blood pressure <65Â mm Hg. The overall survival rate is 12% with a 12% incidence of neurological sequelae. Survival in case of penetrating trauma is 10%, but as high as 20% in case of stab wounds, and only 6% in case of closed trauma. As long as the above-mentioned indications are observed, resuscitation thoracotomy is fully justified in the event of an afflux of injured victims of terrorist attacks.
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Authors
G. Boddaert, E. Hornez, H. De Lesquen, A. Avramenko, B. Grand, T. MacBride, J.-P. Avaro,