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Management of chest trauma in children

Juan A Tovar1, Juan J Vazquez

  • 1Department of Paediatric Surgery, Hospital Universitario La Paz and Department of Paediatrics, Universidad Autonoma de Madrid, Madrid, Spain. juan.tovar@salud.madrid.org

Paediatric Respiratory Reviews
|April 20, 2013
PubMed

Insights

Pediatric chest trauma, often from high-energy impacts like car accidents, involves injuries such as rib fractures and lung contusions. Treatment focuses on respiratory support and surgical repair, with mortality linked to associated injuries.

Area of Science:

  • Pediatric Trauma Surgery
  • Thoracic Medicine
  • Emergency Medicine

Background:

  • Chest trauma in children typically results from high-energy impacts, frequently associated with traffic accidents.
  • Injuries predominantly affect children in their first decade of life and can be penetrating or non-penetrating.

Purpose of the Study:

  • To review the common causes, injuries, treatment modalities, and outcomes of pediatric chest trauma.
  • To highlight the challenges in managing specific injuries like tracheobronchial ruptures.

Main Methods:

  • Review of existing literature on pediatric chest trauma.
  • Analysis of injury patterns, treatment strategies, and mortality rates.

Main Results:

  • Common injuries include rib fractures, lung contusions, pneumothorax, and haemothorax.
  • Less common but severe injuries involve the tracheobronchial tree, heart, esophagus, and diaphragm.
  • Mortality rates range from 6% to 20%, significantly influenced by associated extra-thoracic injuries, especially head trauma.

Conclusions:

  • Pediatric chest trauma requires comprehensive management including respiratory and hemodynamic support, pleural space drainage, and surgical intervention when necessary.
  • Tracheobronchial and esophageal injuries present unique treatment challenges.
  • Associated injuries, particularly head trauma, are critical determinants of patient outcomes.

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