title: Resuscitative thoracotomy for pediatric trauma in Illinois, 1999 to 2009.
abstract: BACKGROUND
  Outcomes in adults who undergo resuscitative thoracotomy are poor. Few studies have examined the procedure's use in pediatric trauma.
  
  
  METHODS
  The Illinois State Trauma Registry was queried for thoracotomy performed in the emergency department from 1999 to 2009, for patients aged 0 to 15. Injury mechanism, vital signs, and mortality were examined while controlling for injury severity.
  
  
  RESULTS
  Resuscitative thoracotomy was infrequently performed in pediatric trauma (n = 25; 2.3/year). Most patients had suffered penetrating injury. Patients who underwent resuscitative thoracotomy were in extremis, with only 17% demonstrating signs of life upon presentation. Although 6 patients (24%) survived initially, only 2 (8%) survived to hospital discharge.
  
  
  CONCLUSIONS
  Resuscitative thoracotomy was rarely performed in children in Illinois emergency departments. Survival is low for thoracotomy in the emergency department, but some patients who presented with penetrating injuries did have positive outcomes, supporting a continued role for the procedure in select cases.
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 650, Chicago, IL 60611, USA. Electronic address: norman-nicolson@northwestern.edu.
authors.forename: Norman G
authors.initials: NG
authors.lastname: Nicolson
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 650, Chicago, IL 60611, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Schwulst
authors.affiliation: Division of Trauma, Surgical Critical Care and Burns, Department of Surgery, Loyola University Chicago Stritch School of Medicine, 2160 South First Avenue, Maywood, IL 60153, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Esposito
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Northwestern University Feinberg School of Medicine, 676 N Saint Clair, Suite 650, Chicago, IL 60611, USA.
authors.forename: Marie L
authors.initials: ML
authors.lastname: Crandall
mesh_terms: D000293:Adolescent; D002648:Child; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D015601:Injury Severity Score; D008297:Male; D012042:Registries; D012151:Resuscitation; D012189:Retrospective Studies; D013908:Thoracotomy; D014949:Wounds, Nonpenetrating / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D014950:Wounds, Penetrating / Q000401:mortality / Q000473:pathology / Q000601:surgery*
keywords: Pediatric; Resuscitation; Thoracotomy; Trauma