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J Emerg Trauma Shock. 2019 Oct-Dec;12(4):254-259. doi: 10.4103/JETS.JETS_36_19. Epub 2019 Nov 18.

Is Emergency Department Thoracotomy Effective in Trauma Resuscitation? The Retrospective Study of the Emergency Department Thoracotomy in Trauma Patients at Thammasat University Hospital, Thailand.

Author information

1
Department of Surgery, Division of Trauma and Surgical Critical Care, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.

Abstract

Introduction:

The survival rate after the emergency department thoracotomy (EDT) in trauma patients varies from the previous study as 1.6% in blunt injury and 11.2% in penetrating injury. Most of the data came from Europe, the US, South Africa, and Japan. This study aims to identify the success of EDT of trauma patients at Thammasat University Hospital, Thailand, and to evaluate the effectiveness of EDT. This study may be representative data for Southeast Asia.

Materials and Methods:

This retrospective review of 21 consecutive EDT cases which performed by our staffs and chief of general surgery residents between June 2009 and July 2016. Age, gender, injury mechanisms, injury sites, patient transport methods, initial vital signs, fluids and blood component requirements, resuscitation times, laboratory results, and injury severity scores were all analyzed.

Results:

Of the 21 EDT cases, one patient was excluded due to being a nontraumatic case. The remaining twenty patients were primarily young (mean 36.5 years), male (85%), suffering from blunt injuries (75%), of which 45% were predominantly thoracic injuries. Most of the patients presented without any sign of life (75%), and the total time for resuscitation was 43.5 ± 19.6 min. Seven patients (35%) had the return of spontaneous circulation (ROSC) and were successful in being brought to the operating room. Unfortunately, all patients passed away within 24 h of the operation.

Conclusions:

The ROSC rate of EDT in this study was 35%, but with no survival benefit. Therefore, we cannot guarantee that EDT serves as an effective life-saving procedure. However, EDT may play a significant role in treating extremis injured patients.

KEYWORDS:

Emergency department thoracotomy; emergency room thoracotomy; resuscitative thoracotomy; trauma

Conflict of interest statement

Kanlerd A, Sapsamarn N and Auksornchart K have no conflict of interests.

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