Management of the crushed chest.
Thoracic injuries are very common among trauma victims. This article reviews the current literature on the management of multiple aspects of the care of the patient with severe chest injury. The mechanics of chest injury are complex and varied. Chest wall injuries are the most common and noticeable manifestation of thoracic trauma. Overall morbidity and mortality are primarily determined by associated injuries. New ventilatory strategies permit oxygenation of the severely hypoxic patient. Acute pain management modalities offer the potential of decreasing associated pulmonary complications. Surgical chest wall fixation is clearly indicated in extreme cases of pulmonary herniation and chest wall disruption. There are potential benefits of surgical fixation in other settings, although further trials are needed.
Kiraly
Laszlo
L
Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health & Science University, Portland, OR, USA. kiralyl@ohsu.edu
Schreiber
Martin
M
D003422:Critical Care / Q000379:methods*; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D011859:Radiography; D012121:Respiration, Artificial; D013898:Thoracic Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D035441:Thoracic Wall / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery