Cardiac and thoracic vascular injuries: anesthetic considerations

Heart and thoracic vascular injuries account for 1% to 4% of trauma, but the potential for mortality and morbidity makes preanesthetic evaluation important. A rational management plan initiated from the time the patient is first seen in the emergency room will guide anesthetic management. Our review of 65 patients with cardiac and intrathoracic vascular injuries showed the preoperative evaluation facilitates selection of airway and anesthetic management. Extensive monitoring and placement of large intravenous lines allow prompt detection and treatment of hemodynamic deterioration.