Abstract

ASENSIO, Juan A; PETRONE, Patrizio; KIMBRELL, Brian  and  KUNCIR, Eric. Emergency thoracotomy: Critical evaluation of the technique. rev. colomb. cir. [online]. 2006, vol.21, n.2, pp.75-86. ISSN 2011-7582.

Objective: Analysis of the literature of the current status of the Emergency Room thoracotomy. Data collection: Literature review, from the first experiences in its utilization to the most recants studies in the area. Results: The Emergency Room thoracotomy is part of the armamentarium of the modern Trauma Surgeon. Since the introduction in the '60, its utilization is widespread and now is part of the protocols of the resuscitation protocols in all American Trauma Centers. Forty two series were analyzed and 7,035 procedures were found, in which 551 (7.8%) survived. According to the mechanism of injury, 4,482 thoracotomies were performed for penetrating injuries, of which 500 (11,1%) patients survived, and 2,193 thoracotomies were performed for blunt trauma, 35 of which (1,6%) survived. Fourteen series reported neurological prognosis: of 4,520 patients who underwent Emergency Room thoracotomy, 226 (5%) survived, and 34 (15%) experienced neurological sequelae and complications. Of the 1,165 patients that underwent Emergency Room thoracotomy for cardiac injuries, 363 (31,1%) survived. Only four series described Emergency Room thoracotomy in the pediatric population; 142 patients underwent this procedure, 57 of those were due to penetrating injuries, with a survival rate of 12,2%. Conclusion: Emergency Room thoractomy is a valuable tool for the Trauma Surgeon, which must be employed judiciously, and with strict indications. Its misuse may increase the morbility and mortality rates. The Emergency Room thoracotomy is still the last hope for many patients that arrive "in extremis". This procedure must be performed by appropriately trained surgeons in the use of this technique.

Keywords : thoracotomy; emergencies; wounds and injuries; heart injuries; thoracic injuries.

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