Skip to main content Accessibility help
  • Print publication year: 2015
  • Online publication date: April 2015

Chapter 30 - Anesthesia considerations for cardiothoracic trauma

from Section 3 - Anesthetic considerations

Related content

Powered by UNSILO


1. Lockey D, Crewdson K, Davies G. Traumatic cardiac arrest: who are the survivors? Ann Emerg Med 2006; 48: 240–4.
2. Tobin JM, Varon AJ. Review article: update in trauma anesthesiology: perioperative resuscitation management. Anesth Analg 2012; 115: 1326–33.
3. Cook CC, Gleason TG. Great vessel and cardiac trauma. Surg Clin North Am 2009; 89: 797–820, viii.
4. Navid F, Gleason TG. Great vessel and cardiac trauma: diagnostic and management strategies. Semin Thorac Cardiovasc Surg 2008; 20: 31–8.
5. Ho AM, Karmakar MK, Critchley LA. Acute pain management of patients with multiple fractured ribs: a focus on regional techniques. Curr Opin Crit Care 2011; 17: 323–7.
6. De Cosmo G, Aceto P, Gualtieri E, Congedo E. Analgesia in thoracic surgery: review. Minerva Anestesiol 2009; 75: 393–400.
7. Chelly JE. Paravertebral blocks. Anesthesiol Clin 2012; 30: 75–90.
8. Co SJ, Yong-Hing CJ, Galea-Soler S, et al. Role of imaging in penetrating and blunt traumatic injury to the heart. Radiographics 2011; 31: E101–15.
9. Singh KE, Baum VC. The anesthetic management of cardiovascular trauma. Curr Opin Anaesthesiol 2011; 24: 98–103.
10. Restrepo CS, Gutierrez FR, Marmol-Velez JA, Ocazionez D, Martinez-Jimenez S. Imaging patients with cardiac trauma. Radiographics 2012; 32: 633–49.
11. Moore EE, Malangoni MA, Cogbill TH, et al. Organ injury scaling. IV: Thoracic vascular, lung, cardiac, and diaphragm. J Trauma 1994; 36: 299–300.
12. Blackbourne LH, Baer DG, Eastridge BJ, et al. Military medical revolution: military trauma system. J Trauma Acute Care Surg 2012; 73: S388–94.
13. Blackbourne LH, Baer DG, Eastridge BJ, et al. Military medical revolution: prehospital combat casualty care. J Trauma Acute Care Surg 2012; 73: S372–7.
14. Blackbourne LH, Baer DG, Eastridge BJ, et al. Military medical revolution: deployed hospital and en route care. J Trauma Acute Care Surg 2012; 73: S378–87.
15. Ivey KM, White CE, Wallum TE, et al. Thoracic injuries in US combat casualties: a 10-year review of Operation Enduring Freedom and Iraqi Freedom. J Trauma Acute Care Surg 2012; 73: S514–19.
16. Roberts I, Shakur H, Coats T, et al. The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess 2013; 17: 1–79.
17. Wade CE, Eastridge BJ, Jones JA, et al. Use of recombinant factor VIIa in US military casualties for a five-year period. J Trauma 2010; 69: 353–9.
18. Nishijima DK, Zehtabchi S. Evidence-based emergency medicine/critically appraised topic. The efficacy of recombinant activated factor VII in severe trauma. Ann Emerg Med 2009; 54: 737–44.e1.
19. Smith JE, Fawcett R, Randalls B. The use of recombinant activated factor VII in a patient with penetrating chest trauma and ongoing pulmonary hemorrhage. Mil Med 2012; 177: 614–16.
20. Orliaguet G, Ferjani M, Riou B. The heart in blunt trauma. Anesthesiology 2001; 95: 544–8.
21. Teixeira PG, Georgiou C, Inaba K, et al. Blunt cardiac trauma: lessons learned from the medical examiner. J Trauma 2009; 67: 1259–64.
22. Battle CE, Hutchings H., Evans PA. Risk factors that predict mortality in patients with blunt chest wall trauma: a systematic review and meta-analysis. Injury 2012; 43: 8–17.
23. Leibecke T, Stoeckelhuber BM, Gellissen J, et al. Posttraumatic and postoperative cardiac luxation: computed tomography findings in nine patients. J Trauma 2008; 64: 721–6.
24. Bertinchant JP, Robert E, Polge A, et al. Release kinetics of cardiac troponin I and cardiac troponin T in effluents from isolated perfused rabbit hearts after graded experimental myocardial contusion. J Trauma 1999; 47: 474–80.
25. Pretre R, Chilcott M. Blunt trauma to the heart and great vessels. N Engl J Med 1997; 336: 626–32.
26. Sutherland GR, Calvin JE, Driedger AA, Holliday RL, Sibbald WJ. Anatomic and cardiopulmonary responses to trauma with associated blunt chest injury. J Trauma 1981; 21: 1–12.
27. Robert E, de La Coussaye JE, Aya AG, et al. Mechanisms of ventricular arrhythmias induced by myocardial contusion: a high-resolution mapping study in left ventricular rabbit heart. Anesthesiology 2000; 92: 1132–43.
28. Sato Y, Matsumoto N, Komatsu S, et al. Coronary artery dissection after blunt chest trauma: depiction at multidetector-row computed tomography. Int J Cardiol 2007; 118: 108–10.
29. Chirillo F, Totis O, Cavarzerani A, et al. Usefulness of transthoracic and transoesophageal echocardiography in recognition and management of cardiovascular injuries after blunt chest trauma. Heart 1996; 75: 301–6.
30. Wall MJ, Mattox KL, Chen CD, Baldwin JC. Acute management of complex cardiac injuries. J Trauma 1997; 42: 905–12.
31. Degiannis E, Loogna P, Doll D, et al. Penetrating cardiac injuries: recent experience in South Africa. World J Surg 2006; 30: 1258–64.
32. Hunt PA, Greaves I, Owens WA. Emergency thoracotomy in thoracic trauma-a review. Injury 2006; 37: 1–19.
33. Singh R, Choudhury M, Kapoor PM, Kiran U. A randomized trial of anesthetic induction agents in patients with coronary artery disease and left ventricular dysfunction. Ann Card Anaesth 2010; 13: 217–23.
34. Lim R, Gill IS, Temes RT, Smith CE. The use of adenosine for repair of penetrating cardiac injuries: a novel method. Ann Thorac Surg 2001; 71: 1714–15.
35. Hoffer EK, Forauer AR, Silas AM, Gemery JM. Endovascular stent-graft or open surgical repair for blunt thoracic aortic trauma: systematic review. J Vasc Interv Radiol 2008; 19: 1153–64.
36. Demetriades D, Velmahos GC, Scalea TM, et al. Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma Multicenter Study. J Trauma 2008; 64: 561–70.
37. Demetriades D, Velmahos GC, Scalea TM, et al. Diagnosis and treatment of blunt thoracic aortic injuries: changing perspectives. J Trauma 2008; 64: 1415–19.
38. Demetriades D, Velmahos GC, Scalea TM, et al. Blunt traumatic thoracic aortic injuries: early or delayed repair–results of an American Association for the Surgery of Trauma prospective study. J Trauma 2009; 66: 967–73.
39. Lachat ML, Pfammatter T, Witzke HJ, et al. Endovascular repair with bifurcated stent-grafts under local anaesthesia to improve outcome of ruptured aortoiliac aneurysms. Eur J Vasc Endovasc Surg 2002; 23: 528–36.
40. Karmy-Jones R, Hoffer E, Meissner M, Bloch RD. Management of traumatic rupture of the thoracic aorta in pediatric patients. Ann Thorac Surg 2003; 75: 1513–17.
41. Williams JS, Graff JA, Uku JM, Steinig JP. Aortic injury in vehicular trauma. Ann Thorac Surg 1994; 57: 726–30.
42. Fann JI, Miller DC. Aortic dissection. Ann Vasc Surg 1995; 9: 311–23.
43. Burns JM, Sing RF, Mostafa G, et al. The role of transesophageal echocardiography in optimizing resuscitation in acutely injured patients. J Trauma 2005; 59: 36–40.
44. Lord MS, Augoustides JG. Perioperative management of pheochromocytoma: focus on magnesium, clevidipine, and vasopressin. J Cardiothorac Vasc Anesth 2012; 26: 526–31.
45. Murphy MB, Murray C, Shorten GD. Fenoldopam: a selective peripheral dopamine-receptor agonist for the treatment of severe hypertension. N Engl J Med 2001; 345: 1548–57.
46. Gilbert TB, Hasnain JU, Flinn WR, Lilly MP, Benjamin ME. Fenoldopam infusion associated with preserving renal function after aortic cross-clamping for aneurysm repair. J Cardiovasc Pharmacol Ther 2001; 6: 31–6.
47. Halpenny M, Rushe C, Breen P, et al. The effects of fenoldopam on renal function in patients undergoing elective aortic surgery. Eur J Anaesthesiol 2002; 19: 32–9.
48. Papia G, Klein D, Lindsay TF. Intensive care of the patient following open abdominal aortic surgery. Curr Opin Crit Care 2006; 12: 340–5.
49. Oliver WC, Nuttall GA, Cherry KJ, et al. A comparison of fenoldopam with dopamine and sodium nitroprusside in patients undergoing cross-clamping of the abdominal aorta. Anesth Analg 2006; 103: 833–40.
50. Sheinbaum R, Ignacio C, Safi HJ, Estrera A. Contemporary strategies to preserve renal function during cardiac and vascular surgery. Rev Cardiovasc Med 2003; 4 (Suppl 1): S21–8.
51. Tobias JD. Dexmedetomidine in trauma anesthesiology and critical care. Trauma Care 2007; 17: 6–18.
52. Gerlach AT, Dasta JF. Dexmedetomidine: an updated review. Ann Pharmacother 2007; 41: 245–52.
53. Koca U, Olguner CG, Ergur BU, et al. The effects of dexmedetomidine on secondary acute lung and kidney injuries in the rat model of intra-abdominal sepsis. ScientificWorldJournal 2013; 2013: 292687.
54. Wu X, Song X, Li N, et al. Protective effects of dexmedetomidine on blunt chest trauma-induced pulmonary contusion in rats. J Trauma Acute Care Surg 2013; 74: 524–30.
55. Geze S, Cekic B, Imamoglu M, et al. Use of dexmedetomidine to prevent pulmonary injury after pneumoperitoneum in ventilated rats. Surg Laparosc Endosc Percutan Tech 2012; 22: 447–53.
56. Schoeler M, Loetscher PD, Rossaint R, et al. Dexmedetomidine is neuroprotective in an in vitro model for traumatic brain injury. BMC Neurol 2012; 12: 20.
57. Zhang XY, Liu ZM, Wen SH, et al. Dexmedetomidine administration before, but not after, ischemia attenuates intestinal injury induced by intestinal ischemia-reperfusion in rats. Anesthesiology 2012; 116: 1035–46.
58. Hayter RG, Rhea JT, Small A, Tafazoli FS, Novelline RA. Suspected aortic dissection and other aortic disorders: multi-detector row CT in 373 cases in the emergency setting. Radiology 2006; 238: 841–52.
59. Kirton OC, Civetta JM. Do pulmonary artery catheters alter outcome in trauma patients? New Horiz 1997; 5: 222–7.
60. Shoemaker WC, Wo CC, Chien LC, et al. Evaluation of invasive and noninvasive hemodynamic monitoring in trauma patients. J Trauma 2006; 61: 844–53.
61. Karski JM. Transesophageal echocardiography in the intensive care unit. Semin Cardiothorac Vasc Anesth 2006; 10: 162–6.
62. Campos JH. Lung isolation techniques. Anesthesiol Clin North America 2001; 19: 455–74.
63. Campos JH. Current techniques for perioperative lung isolation in adults. Anesthesiology 2002; 97: 1295–301.
64. Campos JH. Which device should be considered the best for lung isolation: double-lumen endotracheal tube versus bronchial blockers. Curr Opin Anaesthesiol 2007; 20: 27–31.
65. Sessler DI. Temperature monitoring and perioperative thermoregulation. Anesthesiology 2008; 109: 318–38.
66. Shore-Lesserson, L. Evidence based coagulation monitors: heparin monitoring, thromboelastography, and platelet function. Semin Cardiothorac Vasc Anesth 2005; 9: 41–52.
67. Casati A, Alessandrini P, Nuzzi M, et al. A prospective, randomized, blinded comparison between continuous thoracic paravertebral and epidural infusion of 0.2% ropivacaine after lung resection surgery. Eur J Anaesthesiol, 2006; 1–6.
68. Davies RG, Myles PS, Graham JM. A comparison of the analgesic efficacy and side-effects of paravertebral vs epidural blockade for thoracotomy–a systematic review and meta-analysis of randomized trials. Br J Anaesth 2006; 96: 418–26.
69. Leissner KB, Ortega R, Beattie WS. Anesthesia implications of blast injury. J Cardiothorac Vasc Anesth 2006; 20: 872–80.
70. Gutierrez de Ceballos JP, Turegano Fuentes F, Perez Diaz D, et al. Casualties treated at the closest hospital in the Madrid, March 11, terrorist bombings. Crit Care Med 2005; 33: S107–12.
71. DePalma RG, Burris DG, Champion HR, Hodgson MJ. Blast injuries. N Engl J Med 2005; 352: 1335–42.
72. Biocina B, Sutlic Z, Husedzinovic I, et al. Penetrating cardiothoracic war wounds. Eur J Cardiothorac Surg 1997; 11: 399–405.
73. Shamir MY, Weiss YG, Willner D, et al. Multiple casualty terror events: the anesthesiologist’s perspective. Anesth Analg 2004; 98: 1746–52.
74. Wolf YG, Rivkind A. Vascular trauma in high-velocity gunshot wounds and shrapnel-blast injuries in Israel. Surg Clin North Am 2002; 82: 237–44.
75. Ho AM, Ling E. Systemic air embolism after lung trauma. Anesthesiology 1999; 90: 564–75.
76. O’Connor JV, Adamski, J. The diagnosis and treatment of non-cardiac thoracic trauma. J R Army Med Corps 2010; 156: 5–14.
77. Shim HS, Noe MH, Kim IK, Shin NK, Lee SH. Anesthetic management of a patient with complete trachial transection by blunt trauma: a case report. Korean J Anesthesiol 2008; 54: 454–8.
78. Chow E, Farrar DJ. Right heart function during prosthetic left ventricular assistance in a porcine model of congestive heart failure. J Thorac Cardiovasc Surg 1992; 104: 569–78.
79. Nakagiri T, Inoue M, Nakagawa J, Okumura M. Blunt tracheal transection repair requiring open abdominal management. Ann Thorac Surg 2011; 92: 2248–50.
80. Cohn SM. Pulmonary contusion: review of the clinical entity. J Trauma 1997; 42: 973–9.
81. Eberhard LW, Morabito DJ, Matthay MA, et al. Initial severity of metabolic acidosis predicts the development of acute lung injury in severely traumatized patients. Crit Care Med 2000; 28: 125–31.
82. Karmy-Jones R, Jurkovich GJ. Blunt chest trauma. Curr Probl Surg 2004; 41: 211–380.
83. Keene DD, Rea WE, Aldington D. Acute pain management in trauma. Trauma 2011; 13: 167–79.
84. Simon B, Ebert J, Bokhari F, et al. Management of pulmonary contusion and flail chest: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg 2012; 73: S351–61.
85. Alexander JQ, Gutierrez CJ, Mariano MC, et al. Blunt chest trauma in the elderly patient: how cardiopulmonary disease affects outcome. Am Surg 2000; 66: 855–7.
86. Ullman DA, Fortune JB, Greenhouse BB, Wimpy RE, Kennedy TM. The treatment of patients with multiple rib fractures with continuous thoracic epidural narcotic infusion. Reg Anesth 1989; 14: 43–7.
87. Wisner DH. A stepwise logistic regression analysis of factors affecting morbidity and mortality after thoracic trauma: effect of epidural analgesia. J Trauma 1990; 30: 799–804.
88. Mackersie RC, Karagianes TG, Hoyt DB, Davis JW. Prospective evaluation of epidural and intravenous administration of fentanyl for pain control and restoration of ventilatory function following multiple rib fractures. J Trauma 1991; 31: 443–9.
89. Bulger EM, Edwards T, Klotz P, Jurkovich GJ. Epidural analgesia improves outcome after multiple rib fractures. Surgery 2004; 136: 426–30.