title: Next-generation airbags and the possibility of negative outcomes due to thoracic injury.
abstract: Airbags have been shown to decrease morbidity and mortality associated with motor vehicle accidents when used in conjunction with seat belts. Airbag deployment alone however, has recently been implicated as a cause of significant thoracic injuries to unrestrained drivers. Resulting injuries include major cardiovascular and pulmonary complications. Airbags provide safety to occupants of cars and reduce mortality by 25%-30%. When not used in accordance with international standards, however, they can cause serious injury. We searched online databases from 1970 to January 2013 and included 17 retrospective studies, 12 systematic review articles, 18 case reports, 5 prospective studies, 1 lab study, 3 cohort studies, and 1 meta-analysis. Outcomes included clinical/functional response, left ventricular remodelling, hospitalizations, and mortality. Physicians must maintain a high index of suspicion for injury when evaluating drivers who were not wearing seat belts when airbags deployed, regardless of the speed of the collision, because increased risk of thoracic injury with airbags has been described in the literature. Our review indicates that even new technology, specifically the side air bag, has been associated with a risk of thoracic injury. Considering that regulations are a driving force for airbag technology, further research and scrutiny by medical teams is needed to consider the effects of airbag technology advancements on morbidity and mortality rates of car accidents, to help in guiding further improvement, and to help lawmakers in implementing rules that protect the safety of occupants.
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, University of Health Science Center, Memphis, Tennessee, USA. Electronic address: khouzamrami@yahoo.com.
authors.forename: Rami N
authors.initials: RN
authors.lastname: Khouzam
authors.affiliation: Damascus University Faculty of Medicine, Damascus, Syria.
authors.forename: Saleem
authors.initials: S
authors.lastname: Al-Mawed
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, University of Health Science Center, Memphis, Tennessee, USA.
authors.forename: Victor
authors.initials: V
authors.lastname: Farah
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, University of Health Science Center, Memphis, Tennessee, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Mizeracki
mesh_terms: D000063:Accidents, Traffic; D017278:Air Bags / Q000009:adverse effects*; D000465:Algorithms; D003952:Diagnostic Imaging; D004562:Electrocardiography; D004867:Equipment Design; D006801:Humans; D019810:Sodium Azide / Q000009:adverse effects; D013898:Thoracic Injuries / Q000175:diagnosis / Q000209:etiology*; D014336:Troponin / Q000097:blood; D014949:Wounds, Nonpenetrating / Q000209:etiology*
chemical_list: D014336:Troponin; D019810:Sodium Azide