Yoğun Bakımda Toraks Travmalarına Yaklaşım
Özet
Travmalar 40 yaş altı en sık ölüm sebebidir ve toraks travmaları bu ölümlerin yaklaşık çeyreğinden sorumludur. Toraks travmaları künt ve penetran olarak iki ana başlık altında incelenir. Künt travma sonucu oluşan patolojiler büyük oranda konservatif yöntemler ile tedavi edilebilirken, tanı bazen karmaşık ve tedavi süreci zorlu olabilir. Penetran travmalarda ise tanı nerede ise ek radyolojik incelemeye gerek kalmadan öngörülebilir ve hemen tamamında cerrahi girişimde bulunmak gerekir. Toraks travma hastalarının sağaltımında dikkat edilmesi gereken; tüm travma hastalarında olduğu gibi, gözden kaçırıldığında mortalite veya ciddi morbidite sebebi olabilecek patolojileri çabuk saptayıp uygun tedaviyi uygulamak olmalıdır.
Referanslar
Advanced trauma life support (ATLS®): the ninth edition. J Trauma Acute Care Surg. 74. United States2013. p. 1363-6.
Reija MG, Fernández-Barriales M, Terán TG, Santolino SS. Traumatic lingual haematoma: Another unusual cause of upper airway obstruction in systemic lupus erythematosus. Trauma Case Rep. 2019;23:100226.
Ma DS, Chang SW, Kim DH. Unusual airway obstruction due to thoracic duct injury after whiplash injury. Ulus Travma Acil Cerrahi Derg. 2021;27(4):478-82.
Lee J, Kim JS, Kang S, Shin YS, Doo AR. Prediction of difficult airway management in traumatic cervical spine injury: influence of retropharyngeal space extension. Ther Clin Risk Manag. 2019;15:669-75.
Tran J, Haussner W, Shah K. Traumatic Pneumothorax: A Review of Current Diagnostic Practices And Evolving Management. 2021;61(5):517-28.
Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. European Journal of Cardio-Thoracic Surgery. 2003;23(3):374-8.
Azizi N, ter Avest E, Hoek AE, Admiraal-van de Pas Y, Buizert PJ, Peijs DR, et al. Optimal anatomical location for needle chest decompression for tension pneumothorax: A multicenter prospective cohort study. Injury. 2021;52(2):213-8.
Mandt MJ, Hayes K, Severyn F, Adelgais K. Appropriate Needle Length for Emergent Pediatric Needle Thoracostomy Utilizing Computed Tomography. Prehosp Emerg Care. 2019;23(5):663-71.
Kirkpatrick AW, Sirois M, Laupland KB, Liu D, Rowan K, Ball CG, et al. Hand-held thoracic sonography for detecting post-traumatic pneumothoraces: the Extended Focused Assessment with Sonography for Trauma (EFAST). J Trauma. 57. United States2004. p. 288-95.
Staub LJ, Biscaro RRM, Kaszubowski E, Maurici R. Chest ultrasonography for the emergency diagnosis of traumatic pneumothorax and haemothorax: A systematic review and meta-analysis. Injury. 49. Netherlands: © 2018 Elsevier Ltd; 2018. p. 457-66.
Sharma A, Jindal P. Principles of diagnosis and management of traumatic pneumothorax. J Emerg Trauma Shock. 2008;1(1):34-41.
Bou Zein Eddine S, Boyle KA, Dodgion CM, Davis CS, Webb TP, Juern JS, et al. Observing pneumothoraces: The 35-millimeter rule is safe for both blunt and penetrating chest trauma. J Trauma Acute Care Surg. 2019;86(4):557-64.
Molnar TF. Thoracic Trauma: Which Chest Tube When and Where? Thorac Surg Clin. 27. United States: © 2016 Elsevier Inc; 2017. p. 13-23.
Tokuda R, Okada Y, Nagashima F, Kobayashi M, Ishii W, Iizuka R. Open pneumothorax with extensive thoracic defects sustained in a fall: a case report. Surg Case Rep. 2022;8(1):204.
Brooks A, Davies B, Smethhurst M, Connolly J. Emergency ultrasound in the acute assessment of haemothorax. Emerg Med J. 2004;21(1):44-6.
Choi J, Villarreal J, Andersen W, Min JG, Touponse G, Wong C, et al. Scoping review of traumatic hemothorax: Evidence and knowledge gaps, from diagnosis to chest tube removal. Surgery. 170. United States: © 2021 Elsevier Inc; 2021. p. 1260-7.
Broderick SR. Hemothorax: Etiology, diagnosis, and management. Thorac Surg Clin. 23. United States: © 2013 Elsevier Inc; 2013. p. 89-96, vi-vii.
Patel NJ, Dultz L, Ladhani HA, Cullinane DC, Klein E, McNickle AG, et al. Management of simple and retained hemothorax: A practice management guideline from the Eastern Association for the Surgery of Trauma. Am J Surg. 2021;221(5):873-84.
Wong WG, Perez Holguin RA, Oh JS, Armen SB, Taylor MD, Reed MF, et al. The cost of treatments for retained traumatic hemothorax: A decision analysis. Injury. 53. Netherlands: © 2022. Published by Elsevier Ltd.; 2022. p. 2930-8.
Vial MR, Ost DE, Eapen GA, Jimenez CA, Morice RC, O'Connell O, et al. Intrapleural Fibrinolytic Therapy in Patients With Nondraining Indwelling Pleural Catheters. J Bronchology Interv Pulmonol. 23. United States2016. p. 98-105.
Stashko E, Meer JM. Cardiac Tamponade. StatPearls. Treasure Island FL: © 2023, StatPearls Publishing LLC.; 2023.
Ishida K, Kinoshita Y, Iwasa N, Nakae M, Sakaki M, Ieki Y, et al. Emergency room thoracotomy for acute traumatic cardiac tamponade caused by a blunt cardiac injury: A case report. Int J Surg Case Rep. 2017;35:21-4.
Elie MC. Blunt cardiac injury. Mt Sinai J Med. 2006;73(2):542-52.
Foot CL. Myocardial contusion. Crit Care Resusc. 2005;7(1):29-31.
Boutros J, Marquette CH, Ichai C, Leroy S, Benzaquen J. Multidisciplinary management of tracheobronchial injury. Eur Respir Rev. 2022;31(163).
Carretta A, Melloni G, Bandiera A, Negri G, Voci C, Zannini P. Conservative and surgical treatment of acute posttraumatic tracheobronchial injuries. World J Surg. 2011;35(11):2568-74.
Pishbin E, Ahmadi K, Foogardi M, Salehi M, Seilanian Toosi F, Rahimi-Movaghar V. Comparison of ultrasonography and radiography in diagnosis of rib fractures. Chin J Traumatol. 2017;20(4):226-8.
Burton SW, Riojas C, Gesin G, Smith CB, Bandy V, Sing R, et al. Multimodal analgesia reduces opioid requirements in trauma patients with rib fractures. J Trauma Acute Care Surg. 2022;92(3):588-96.
Peek J, Smeeing DPJ, Hietbrink F, Houwert RM, Marsman M, de Jong MB. Comparison of analgesic interventions for traumatic rib fractures: a systematic review and meta-analysis. Eur J Trauma Emerg Surg. 2019;45(4):597-622.
Sawyer E, Wullschleger M, Muller N, Muller M. Surgical Rib Fixation of Multiple Rib Fractures and Flail Chest: A Systematic Review and Meta-analysis. J Surg Res. 2022;276:221-34.
de Moya M, Nirula R, Biffl W. Rib fixation: Who, What, When? Trauma Surg Acute Care Open. 2017;2(1):e000059.
Hamrick MC, Duhn RD, Ochsner MG. Critical evaluation of pulmonary contusion in the early post-traumatic period: risk of assisted ventilation. Am Surg. 2009;75(11):1054-8.
Klein Y, Cohn SM, Proctor KG. Lung contusion: pathophysiology and management. Curr Opin Anaesthesiol. 2002;15(1):65-8.
Miller DL, Mansour KA. Blunt traumatic lung injuries. Thorac Surg Clin. 2007;17(1):57-61, vi.
Phillips B, Shaw J, Turco L, McDonald D, Carey J, Balters M, et al. Traumatic pulmonary pseudocyst: An underreported entity. Injury. 2017;48(2):214-20.
Shishido Y, Minami K, Sakanoue I, Takahashi Y, Hamakawa H. Large traumatic pneumatocele treated using video-assisted thoracoscopic surgery. J Trauma Acute Care Surg. 2019;86(6):1039-40.
Asensio JA, Chahwan S, Forno W, MacKersie R, Wall M, Lake J, et al. Penetrating esophageal injuries: multicenter study of the American Association for the Surgery of Trauma. J Trauma. 2001;50(2):289-96.
Vázquez-Rodríguez JC, Pelet Del Toro NM, García-Rodríguez O, Ramos-Meléndez E, López-Maldonado J, Rodríguez F, et al. Traumatic esophageal perforation in Puerto Rico Trauma Hospital: A case-series. Ann Med Surg (Lond). 2019;44:62-7.
Onat S, Ulku R, Cigdem KM, Avci A, Ozcelik C. Factors affecting the outcome of surgically treated non-iatrogenic traumatic cervical esophageal perforation: 28 years experience at a single center. J Cardiothorac Surg. 2010;5:46.
Vermeulen BD, van der Leeden B, Ali JT, Gudbjartsson T, Hermansson M, Low DE, et al. Early diagnosis is associated with improved clinical outcomes in benign esophageal perforation: an individual patient data meta-analysis. Surg Endosc. 2021;35(7):3492-505.
Cheadle GA, Cheadle WG. A Review of "Options in Management of Trauma to the Esophagus" (1982) "Submitted for the Literary Festschrift in Honor of J. David Richardson, MD". Am Surg. 2021;87(2):183-7.
Kuppusamy MK, Hubka M, Felisky CD, Carrott P, Kline EM, Koehler RP, et al. Evolving management strategies in esophageal perforation: surgeons using nonoperative techniques to improve outcomes. J Am Coll Surg. 2011;213(1):164-71; discussion 71-2.
Lajin M, Khan N, Bazerbachi F. Successful endoscopic closure of a large esophageal perforation using the purse-string technique. Endoscopy. 2023;55(S 01):E715-e6.
Llorente K, Evans M, Moore SA, Miskimins R. Endoluminal wound VAC therapy for the management of esophageal trauma: A case series. Trauma Case Rep. 43. Netherlands: © 2022 The Authors.; 2023. p. 100748.
Cangır AK, Nadir A, Akal M, Kutlay H, Özdemir N, Güngör A, et al. THORACIC TRAUMA: ANALYSIS OF 532 PATIENTS. Turkish Journal of Trauma and Emergency Surgery. 2000;6(2):100-5.
Williams M, Carlin AM, Tyburski JG, Blocksom JM, Harvey EH, Steffes CP, et al. Predictors of mortality in patients with traumatic diaphragmatic rupture and associated thoracic and/or abdominal injuries. Am Surg. 2004;70(2):157-62; discussion 62-3.
Bergin D, Ennis R, Keogh C, Fenlon HM, Murray JG. The "dependent viscera" sign in CT diagnosis of blunt traumatic diaphragmatic rupture. AJR Am J Roentgenol. 2001;177(5):1137-40.
Friese RS, Coln CE, Gentilello LM. Laparoscopy is sufficient to exclude occult diaphragm injury after penetrating abdominal trauma. J Trauma. 2005;58(4):789-92.
McDonald AA, Robinson BRH, Alarcon L, Bosarge PL, Dorion H, Haut ER, et al. Evaluation and management of traumatic diaphragmatic injuries: A Practice Management Guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2018;85(1):198-207.
Referanslar
Advanced trauma life support (ATLS®): the ninth edition. J Trauma Acute Care Surg. 74. United States2013. p. 1363-6.
Reija MG, Fernández-Barriales M, Terán TG, Santolino SS. Traumatic lingual haematoma: Another unusual cause of upper airway obstruction in systemic lupus erythematosus. Trauma Case Rep. 2019;23:100226.
Ma DS, Chang SW, Kim DH. Unusual airway obstruction due to thoracic duct injury after whiplash injury. Ulus Travma Acil Cerrahi Derg. 2021;27(4):478-82.
Lee J, Kim JS, Kang S, Shin YS, Doo AR. Prediction of difficult airway management in traumatic cervical spine injury: influence of retropharyngeal space extension. Ther Clin Risk Manag. 2019;15:669-75.
Tran J, Haussner W, Shah K. Traumatic Pneumothorax: A Review of Current Diagnostic Practices And Evolving Management. 2021;61(5):517-28.
Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. European Journal of Cardio-Thoracic Surgery. 2003;23(3):374-8.
Azizi N, ter Avest E, Hoek AE, Admiraal-van de Pas Y, Buizert PJ, Peijs DR, et al. Optimal anatomical location for needle chest decompression for tension pneumothorax: A multicenter prospective cohort study. Injury. 2021;52(2):213-8.
Mandt MJ, Hayes K, Severyn F, Adelgais K. Appropriate Needle Length for Emergent Pediatric Needle Thoracostomy Utilizing Computed Tomography. Prehosp Emerg Care. 2019;23(5):663-71.
Kirkpatrick AW, Sirois M, Laupland KB, Liu D, Rowan K, Ball CG, et al. Hand-held thoracic sonography for detecting post-traumatic pneumothoraces: the Extended Focused Assessment with Sonography for Trauma (EFAST). J Trauma. 57. United States2004. p. 288-95.
Staub LJ, Biscaro RRM, Kaszubowski E, Maurici R. Chest ultrasonography for the emergency diagnosis of traumatic pneumothorax and haemothorax: A systematic review and meta-analysis. Injury. 49. Netherlands: © 2018 Elsevier Ltd; 2018. p. 457-66.
Sharma A, Jindal P. Principles of diagnosis and management of traumatic pneumothorax. J Emerg Trauma Shock. 2008;1(1):34-41.
Bou Zein Eddine S, Boyle KA, Dodgion CM, Davis CS, Webb TP, Juern JS, et al. Observing pneumothoraces: The 35-millimeter rule is safe for both blunt and penetrating chest trauma. J Trauma Acute Care Surg. 2019;86(4):557-64.
Molnar TF. Thoracic Trauma: Which Chest Tube When and Where? Thorac Surg Clin. 27. United States: © 2016 Elsevier Inc; 2017. p. 13-23.
Tokuda R, Okada Y, Nagashima F, Kobayashi M, Ishii W, Iizuka R. Open pneumothorax with extensive thoracic defects sustained in a fall: a case report. Surg Case Rep. 2022;8(1):204.
Brooks A, Davies B, Smethhurst M, Connolly J. Emergency ultrasound in the acute assessment of haemothorax. Emerg Med J. 2004;21(1):44-6.
Choi J, Villarreal J, Andersen W, Min JG, Touponse G, Wong C, et al. Scoping review of traumatic hemothorax: Evidence and knowledge gaps, from diagnosis to chest tube removal. Surgery. 170. United States: © 2021 Elsevier Inc; 2021. p. 1260-7.
Broderick SR. Hemothorax: Etiology, diagnosis, and management. Thorac Surg Clin. 23. United States: © 2013 Elsevier Inc; 2013. p. 89-96, vi-vii.
Patel NJ, Dultz L, Ladhani HA, Cullinane DC, Klein E, McNickle AG, et al. Management of simple and retained hemothorax: A practice management guideline from the Eastern Association for the Surgery of Trauma. Am J Surg. 2021;221(5):873-84.
Wong WG, Perez Holguin RA, Oh JS, Armen SB, Taylor MD, Reed MF, et al. The cost of treatments for retained traumatic hemothorax: A decision analysis. Injury. 53. Netherlands: © 2022. Published by Elsevier Ltd.; 2022. p. 2930-8.
Vial MR, Ost DE, Eapen GA, Jimenez CA, Morice RC, O'Connell O, et al. Intrapleural Fibrinolytic Therapy in Patients With Nondraining Indwelling Pleural Catheters. J Bronchology Interv Pulmonol. 23. United States2016. p. 98-105.
Stashko E, Meer JM. Cardiac Tamponade. StatPearls. Treasure Island FL: © 2023, StatPearls Publishing LLC.; 2023.
Ishida K, Kinoshita Y, Iwasa N, Nakae M, Sakaki M, Ieki Y, et al. Emergency room thoracotomy for acute traumatic cardiac tamponade caused by a blunt cardiac injury: A case report. Int J Surg Case Rep. 2017;35:21-4.
Elie MC. Blunt cardiac injury. Mt Sinai J Med. 2006;73(2):542-52.
Foot CL. Myocardial contusion. Crit Care Resusc. 2005;7(1):29-31.
Boutros J, Marquette CH, Ichai C, Leroy S, Benzaquen J. Multidisciplinary management of tracheobronchial injury. Eur Respir Rev. 2022;31(163).
Carretta A, Melloni G, Bandiera A, Negri G, Voci C, Zannini P. Conservative and surgical treatment of acute posttraumatic tracheobronchial injuries. World J Surg. 2011;35(11):2568-74.
Pishbin E, Ahmadi K, Foogardi M, Salehi M, Seilanian Toosi F, Rahimi-Movaghar V. Comparison of ultrasonography and radiography in diagnosis of rib fractures. Chin J Traumatol. 2017;20(4):226-8.
Burton SW, Riojas C, Gesin G, Smith CB, Bandy V, Sing R, et al. Multimodal analgesia reduces opioid requirements in trauma patients with rib fractures. J Trauma Acute Care Surg. 2022;92(3):588-96.
Peek J, Smeeing DPJ, Hietbrink F, Houwert RM, Marsman M, de Jong MB. Comparison of analgesic interventions for traumatic rib fractures: a systematic review and meta-analysis. Eur J Trauma Emerg Surg. 2019;45(4):597-622.
Sawyer E, Wullschleger M, Muller N, Muller M. Surgical Rib Fixation of Multiple Rib Fractures and Flail Chest: A Systematic Review and Meta-analysis. J Surg Res. 2022;276:221-34.
de Moya M, Nirula R, Biffl W. Rib fixation: Who, What, When? Trauma Surg Acute Care Open. 2017;2(1):e000059.
Hamrick MC, Duhn RD, Ochsner MG. Critical evaluation of pulmonary contusion in the early post-traumatic period: risk of assisted ventilation. Am Surg. 2009;75(11):1054-8.
Klein Y, Cohn SM, Proctor KG. Lung contusion: pathophysiology and management. Curr Opin Anaesthesiol. 2002;15(1):65-8.
Miller DL, Mansour KA. Blunt traumatic lung injuries. Thorac Surg Clin. 2007;17(1):57-61, vi.
Phillips B, Shaw J, Turco L, McDonald D, Carey J, Balters M, et al. Traumatic pulmonary pseudocyst: An underreported entity. Injury. 2017;48(2):214-20.
Shishido Y, Minami K, Sakanoue I, Takahashi Y, Hamakawa H. Large traumatic pneumatocele treated using video-assisted thoracoscopic surgery. J Trauma Acute Care Surg. 2019;86(6):1039-40.
Asensio JA, Chahwan S, Forno W, MacKersie R, Wall M, Lake J, et al. Penetrating esophageal injuries: multicenter study of the American Association for the Surgery of Trauma. J Trauma. 2001;50(2):289-96.
Vázquez-Rodríguez JC, Pelet Del Toro NM, García-Rodríguez O, Ramos-Meléndez E, López-Maldonado J, Rodríguez F, et al. Traumatic esophageal perforation in Puerto Rico Trauma Hospital: A case-series. Ann Med Surg (Lond). 2019;44:62-7.
Onat S, Ulku R, Cigdem KM, Avci A, Ozcelik C. Factors affecting the outcome of surgically treated non-iatrogenic traumatic cervical esophageal perforation: 28 years experience at a single center. J Cardiothorac Surg. 2010;5:46.
Vermeulen BD, van der Leeden B, Ali JT, Gudbjartsson T, Hermansson M, Low DE, et al. Early diagnosis is associated with improved clinical outcomes in benign esophageal perforation: an individual patient data meta-analysis. Surg Endosc. 2021;35(7):3492-505.
Cheadle GA, Cheadle WG. A Review of "Options in Management of Trauma to the Esophagus" (1982) "Submitted for the Literary Festschrift in Honor of J. David Richardson, MD". Am Surg. 2021;87(2):183-7.
Kuppusamy MK, Hubka M, Felisky CD, Carrott P, Kline EM, Koehler RP, et al. Evolving management strategies in esophageal perforation: surgeons using nonoperative techniques to improve outcomes. J Am Coll Surg. 2011;213(1):164-71; discussion 71-2.
Lajin M, Khan N, Bazerbachi F. Successful endoscopic closure of a large esophageal perforation using the purse-string technique. Endoscopy. 2023;55(S 01):E715-e6.
Llorente K, Evans M, Moore SA, Miskimins R. Endoluminal wound VAC therapy for the management of esophageal trauma: A case series. Trauma Case Rep. 43. Netherlands: © 2022 The Authors.; 2023. p. 100748.
Cangır AK, Nadir A, Akal M, Kutlay H, Özdemir N, Güngör A, et al. THORACIC TRAUMA: ANALYSIS OF 532 PATIENTS. Turkish Journal of Trauma and Emergency Surgery. 2000;6(2):100-5.
Williams M, Carlin AM, Tyburski JG, Blocksom JM, Harvey EH, Steffes CP, et al. Predictors of mortality in patients with traumatic diaphragmatic rupture and associated thoracic and/or abdominal injuries. Am Surg. 2004;70(2):157-62; discussion 62-3.
Bergin D, Ennis R, Keogh C, Fenlon HM, Murray JG. The "dependent viscera" sign in CT diagnosis of blunt traumatic diaphragmatic rupture. AJR Am J Roentgenol. 2001;177(5):1137-40.
Friese RS, Coln CE, Gentilello LM. Laparoscopy is sufficient to exclude occult diaphragm injury after penetrating abdominal trauma. J Trauma. 2005;58(4):789-92.
McDonald AA, Robinson BRH, Alarcon L, Bosarge PL, Dorion H, Haut ER, et al. Evaluation and management of traumatic diaphragmatic injuries: A Practice Management Guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2018;85(1):198-207.
