Cuenca DJ, Esperón LI, Trejo SJ

Language: Spanish
References: 16
Page: 38-43
PDF size: 915.45 Kb.

ABSTRACT

Objective: To know the experience and management of 34 patients with traumatic heart injuries admitted to the Emergency and General Hospital "Xoco" in Mexico City. Material And Methods: Between the years 1991-1998 an observational and retrospective study was performed in 34 patients that were admitted for thoracic traumatic injury, and were under surgery because of cardiac injury. Results: 32 male patients and 2 female were included. Stab wound was the most frequent etiology. Clinical data included chest pain, dispnea, shock and tamponade. Radiologically, the main sign was left pleural overflow. Electrocardigraphic findings included sinus tachycardia and fall of the S-T segment. A correlation between the decrease in CK-MB (fraction MB of creatinine kinase enzyme), and a satisfactory outcome was observed. Usually, preanesthetic management was performed with nalbuphine, and anesthetic management with ketamine. Vecuronio was the neuromuscular blocking agent relaxing agents most frequently used. Fentanyl citrate was used as the principal opiod in balanced anesthesia technique. Most of the surgical approaches included right anterolateral thoracotomy. The main findings in the ultrasound study were pericardic overflow and pericarditis. Conclusions: Traumatic cardiac injury is a mortal condition, since there are very few patients that get the Emergency Room alive. Based in our study, the main etiology was stab wounds. Clinical findings included thoracic pain, dispnea, shock and tamponade. Radiologic, electrocardiographic and echocardiographic findings were related with previously reported in medical literature. The decrease in the CK-MB is related with a favorable outcome of the patients. Most frequent preanesthetic management included nalbuphine and the induction drug was ketamine, which provided good efficacy and security.

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