Chest injuries – what is new?

  title={Chest injuries – what is new?},
  author={Marius J. B. Keel and Christoph Meier},
  journal={Current Opinion in Critical Care},
  • M. KeelC. Meier
  • Published 1 December 2007
  • Medicine
  • Current Opinion in Critical Care
Purpose of reviewThis article reviews new aspects about the significance, diagnosis and treatment of different chest injuries. Recent findingsAge and Injury Severity Score were risk factors for pneumonia and mortality in patients with rib fractures or flail chest. Occult pneumothoraces were detected in 14.5% and occult hemothoraces in 21.4% using computed tomography, whereas lung contusions were detected two times more frequently with computed tomography compared with chest X-ray. The current… 

Pain management in thoracic trauma.

The importance of good pain control in the management of thoracic trauma and the available evidence supporting the available modalities including nonpharmacological, pharmacological, regional analgesia, and surgical fixation are discussed.

Gunshot wounds to the chest

Gunshot wounds to the chest are dangerous injuries and in order to decrease mortality, good systems for transportation and experienced personnel are necessary.

[Chest trauma from a surgical perspective].

Patients with multiple injuries in particular frequently also suffer from chest trauma, and especially a flail chest and retained hemothorax are responsible for complications, such as acute lung failure and thoracic empyema.

Extracorporeal lung support in trauma patients with severe chest injury and acute lung failure: a 10-year institutional experience

Pumpless and pump-driven ELS systems are an excellent treatment option in severe thoracic trauma patients with ALF and facilitate survival in an experienced trauma center with an interdisciplinary treatment approach and are encouraged to use vv-ECMO due to reduced complication rates, better oxygenation and best short-term outcome.

Rotational therapy in thoracic injuries: what is the evidence?

The benefit of changing the patients’ position for secret mobilization and recruitment of atelectasis after chest trauma and therefore preventing secondary complications seems to be self-evident, and randomized controlled multicenter trials are necessary to analyze the overall benefit of such means.

Introduction, Epidemiology, and Definition of Chest Wall Injuries

This chapter will discuss some of aspects of this topic that are, at present, unclear in order to introduce the topic to the reader and define parameters relevant to this topic.

Surgical Fixation Compared with Conservative Treatment of Flail Chest Injuries

Surgical internal fixation was found to be superior to conservative treatment for flail chest and no mortality was reported.

Patients with thoracic trauma and concomitant spinal cord injury have a markedly decreased mortality rate compared to patients without spinal cord injury

It is demonstrated that patients with thoracic trauma and concomitant SCI had markedly decreased mortality compared to patients without SCI, even after adjusting for age, sex, injury severity, comorbidities and pneumonia infection.



Unilateral flail chest is seldom a lethal injury

Advanced age is associated with higher mortality in patients with flail chest injuries, and isolated unilateral bony cage instability infrequently leads to death in patients who make it to the emergency department but rather its combination with additional extrathoracic trauma.

Penetrating Cardiac Injuries: Recent Experience in South Africa

A high index of suspicion for penetrating cardiac injury and an understanding of the modes of presentation can lead to rapid diagnosis even by inexperienced junior staff leads to early definitive management and acceptable results.

Value of thoracic computed tomography in the first assessment of severely injured patients with blunt chest trauma: results of a prospective study.

TCT is highly sensitive in detecting thoracic injuries after blunt chest trauma and is superior to routine CXR in visualzing lung contusions, pneumothoraces, and hemothorax and recommended in the initial diagnostic work-up of patients with multiple injuries and with suspected chest trauma.

Acute and long-term clinical significance of myocardial contusion following blunt thoracic trauma: results of a prospective study.

The incidence of 19.7% of MC in patients with blunt chest injury requiring intensive care treatment indicates that this condition is frequent in polytraumatized patients and routine cardiac work-up is not indicated.

Incidence, risk factors, and outcomes for occult pneumothoraces in victims of major trauma.

OptXs are commonly missed both by CXR and even abdominal CT scanning in seriously injured patients, and basic markers available early in resuscitation are highly predictive for OPTXs and may guide management before CT scanning.

Rib fractures: Relationship with pneumonia and mortality*

In a model controlling for multiple known risk factors, age and Injury Severity Score were the only important predictors of mortality in patients with rib fractures and multiple-system injury.

Role of thoracoscopy in acute management of chest injury

The role of video-assisted thoracoscopic surgery in the management of acute chest injury is expanding and is an invaluable tool for the trauma surgeon.