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Blunt chest trauma with deep pulmonary laceration
N Nishiumi1, F Maitani, T Tsurumi
1Department of Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan. nishiumi@is.icc.u-tokai.ac.jp
The Annals of Thoracic Surgery
|February 24, 2001
Summary
Deep pulmonary laceration (DPL) is a rare condition with low survival rates. Key poor prognostic factors include low systolic blood pressure (SBP) and significant intrathoracic blood loss.
Area of Science:
- Trauma Surgery
- Thoracic Surgery
- Emergency Medicine
Background:
- Deep pulmonary laceration (DPL) is a rare and severe thoracic injury.
- Survival rates for DPL are historically low, necessitating identification of prognostic factors.
Observation:
- A retrospective study analyzed 17 patients with DPL treated between 1988 and 1998.
- Prognostic factors evaluated included systolic blood pressure (SBP), PaO2, and intrathoracic blood loss volume.
- Initial chest roentgenogram findings were also investigated.
Findings:
- Systolic blood pressure (SBP) below 80 mm Hg on arrival and over 1,000 mL of chest tube blood loss within 2 hours were identified as poor prognostic indicators.
- Hypoxemia on arrival was not found to be a poor prognostic factor.
- Chest X-rays revealed characteristic macular infiltrative shadows, lung collapse, and mediastinal deviation.
Implications:
- Early identification of low SBP and significant blood loss can aid in risk stratification for DPL patients.
- Findings can inform clinical decision-making and resource allocation in managing severe thoracic trauma.
- Selective bronchial occlusion is a viable technique to manage airway blood contamination.