Related Experiment Video
Updated: Oct 31, 2025
08:14
Capturing the Cardiac Injury Response of Targeted Cell Populations via Cleared Heart Three-Dimensional Imaging
Published on: March 17, 2020
6.1K
Damage control in penetrating cardiac trauma
Adolfo González-Hadad1,2,3, Carlos A Ordoñez1,4,5, Michael W Parra6
1Universidad del Valle, Facultad de Salud, Escuela de Medicina, Department of Surgery, Division of Trauma and Acute Care Surgery. Cali, Colombia.
Colombia Medica (Cali, Colombia)
|June 30, 2021
Summary
For penetrating cardiac injuries, trans-thoracic ultrasound guides management. Pericardial lavage and drainage can avoid open chest exploration in stable patients, but unstable patients may need damage control surgery.
Area of Science:
- Trauma Surgery
- Cardiothoracic Surgery
- Emergency Medicine
Background:
- Management of penetrating cardiac injuries lacks consensus, particularly regarding invasive versus non-operative strategies.
- Damage control surgery is considered for hemodynamically unstable patients with these injuries.
Purpose of the Study:
- To present an algorithm for surgical management of penetrating cardiac injuries.
- To integrate damage control surgery principles into the algorithm.
- To highlight the role of pericardial lavage and drainage.
Main Methods:
- Proposed algorithm for penetrating cardiac injury management.
- Utilized trans-thoracic ultrasound for initial evaluation of precordial injuries.
- Incorporated pericardial window with lavage and drainage for stable patients with positive ultrasound findings.
- Considered damage control surgery for hemodynamically unstable patients.
Main Results:
- Trans-thoracic ultrasound is recommended for all precordial penetrating injuries.
- Pericardial lavage and drainage can obviate open chest exploration in a subset of patients (approx. 75%).
- Damage control surgery remains essential for managing ongoing hemorrhage in unstable patients.
Conclusions:
- A structured algorithm incorporating ultrasound, pericardial lavage/drainage, and damage control surgery optimizes care for penetrating cardiac injuries.
- Pericardial lavage and drainage offers a less invasive option for selected hemodynamically stable patients.
- Damage control surgery is critical for hemodynamically unstable patients requiring immediate bleeding control.
Related Concept Videos
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
161
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
161
01:23Cardiopulmonary Resuscitation III: AED Use
173
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
173
01:28Acute Coronary Syndrome IV: Interprofessional Care
69
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
69
01:26Flail Chest-II
315
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
315
01:21Cardiopulmonary Resuscitation I: Adult
235
Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
235
01:14Prevention of Further Absorption of Poison
1.0K
In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
1.0K