Combined severe myocardial and pulmonary contusion: early diagnosis with transesophageal echocardiography and management with high-frequency jet ventilation: case report.
We report the case of a 27-year-old patient with blunt thoracic trauma in whom transesophageal echocardiography enabled an early diagnosis of severe myocardial contusion. Conventional mechanical ventilation dramatically enhanced cardiogenic shock because of myocardial contusion, requiring increasing doses of catecholamine. High-frequency jet ventilation produced an immediate improvement in hemodynamic status, permitting a decrease in catecholamine administration.
Orliaguet
G
G
Department of Anesthesiology and Critical Care, C.H.U. Pitié-Salpêtriere, Paris, France.
Jacquens
Y
Y
Riou
B
B
Le Bret
F
F
Rouby
J J
JJ
Viars
P
P
D000328:Adult; D002303:Cardiac Output, Low / Q000209:etiology; D003288:Contusions / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D004452:Echocardiography / Q000379:methods*; D006335:Heart Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics; D006611:High-Frequency Jet Ventilation; D006801:Humans; D055370:Lung Injury; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D014947:Wounds and Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy