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La toracotomía de emergencia en el manejo del trauma
JAMA
|April 8, 1983
Resumen
La toracotomía de la sala de emergencias es efectiva para las lesiones penetrantes en el pecho, pero menos para el trauma contundente o las lesiones por debajo del diafragma. Los resultados del paciente dependen en gran medida del tipo y la ubicación de la lesión.
Área de la Ciencia:
- Trauma Cirugía cirugía cirugía.
- Medicina de emergencia Medicina de emergencia.
- Cirugía torácica cirugía torácica.
Sus antecedentes:
- El uso de la toracotomía de la sala de emergencias (ERT) en el manejo del trauma está aumentando.
- Su eficacia está bien establecida para las lesiones torácicas penetrantes, pero se debate para otros tipos de traumas.
Objetivo del estudio:
- Aclarar el papel y la eficacia de la ERT en diversos escenarios de trauma.
- Para identificar los factores que influyen en los resultados de los pacientes después de ERT.
Principales métodos:
- Revisión de la literatura existente y estudios de casos sobre ERT en el trauma.
- Análisis de los resultados de los pacientes en función del tipo de lesión (penetración torácica, penetración por debajo del diafragma, trauma contundente) y la ubicación.
Principales resultados:
- ERT es más eficaz para la penetración de lesiones cardíacas y torácicas.
- Los resultados son más pobres para las lesiones penetrantes por debajo del diafragma y peores para el trauma torácico-abdominal contundente.
- La ubicación anatómica y el mecanismo de la lesión tienen un impacto significativo en las tasas de éxito de ERT.
Conclusiones:
- La ERT es una intervención valiosa para el trauma torácico penetrante específico.
- La selección cuidadosa del paciente basada en las características de la lesión es crucial para optimizar los resultados de la TRE.
- Se necesita más investigación para establecer directrices claras para la TRE en casos de trauma no torácico y contundente.
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