首页|Emergency Resuscitative Thoracotomy for Civilian Thoracic Trauma in the Field and Emergency Department Settings: A Systematic Review and Meta-Analysis

Emergency Resuscitative Thoracotomy for Civilian Thoracic Trauma in the Field and Emergency Department Settings: A Systematic Review and Meta-Analysis

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  • NSTL
  • Elsevier
Background: Emergency department resuscitative thoracotomy (ED-RT) or prehospital resuscitative thoracotomy (PH-RT) is performed for trauma patients with impending or full cardiovascular collapse. This systematic review and meta-analysis analyze outcomes in patients with thoracic trauma receiving PH-RT and ED-RT. Methods: PubMed, JAMA Network, and CINAHL electronic databases were searched to identify studies published on ED-RT or PH-RT between 2000-2020. Patients were grouped by location of procedure and type of thoracic injury (blunt versus penetrating). Results: A total of 49 studies met the criteria for qualitative analysis, and 43 for quantitative analysis. 43 studies evaluated ED-RT and 5 evaluated PH-RT. Time from arrival on scene to PH-RT > 5 min was associated with increased neurological complications and time from the initial encounter to PH-RT or ED-RT > 10 min was associated with increased mortality. ISS > 25 and absent signs of life were also associated with increased mortality. There was higher mortality in all PH-RT (93.5%) versus all ED-RT (81.8%) ( P = 0.02). Among ED-RTs, a significant difference was found in mortality rate between patients with blunt (92.8%) versus penetrating (78.7%) injuries ( P < 0.001). When considering only blunt or penetrating injury types, no significant difference in RT mortality rate was found between ED-RT and PH-RT ( P = 0.65 and P = 0.95, respectively). Conclusions: ED-RT and PH-RT are potentially life-saving procedures for patients with penetrating thoracic injuries in extremis and with signs of life. The efficacy of this procedure is time sensitive. Moreover, there appears to be a greater mortality risk for patients with thoracic trauma receiving RT in the PH setting compared to the ED setting. More studies are needed to determine the significance of PH-RT mortality. (c) 2021 Published by Elsevier Inc.

ED thoracotomyPrehospital thoracotomyField resuscitationTrauma outcomesThoracic blunt and penetrating traumaPRACTICE MANAGEMENT GUIDELINEPENETRATING CARDIAC INJURIESEASTERN ASSOCIATIONURGENT THORACOTOMYMORTALITYWOUNDSBLUNTPREDICTORSSURVIVALOUTCOMES

Liu, Amy、Nguyen, Jackie、Ehrlich, Haley、Bisbee, Charles、Santiesteban, Luis、Santos, Radleigh、McKenney, Mark、Elkbuli, Adel

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Dept Surg,Kendall Reg Med Ctr

Dept Math,Nova Southeastern Univ

2022

10.1016/j.jss.2021.11.012

The Journal of surgical research.

The Journal of surgical research.

ISSN：0022-4804
年,卷(期)：2022.273
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