scholarly journals Thoracic Anesthesia and Cross Field Ventilation for Tracheobronchial Injuries: A Challenge for Anesthesiologists

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sankalp Sehgal ◽  
Joshua C. Chance ◽  
Matthew A. Steliga
Keyword(s):  
Pain Control ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Lung Ventilation ◽  
Postoperative Pain Control ◽  
One Lung Ventilation ◽  
Tracheal Reconstruction ◽  
Thoracic Anesthesia ◽  
Tracheobronchial Injuries ◽  
Life Threatening

Tracheobronchial injuries are rare but life threatening sequel of blunt chest trauma. Due to the difficult nature of these injuries and the demanding attributes of the involved surgery, the anesthesiologist faces tough challenges while securing the airway, controlling oxygenation, undertaking one-lung ventilation, maintaining anesthesia during tracheal reconstruction, and gaining adequate postoperative pain control. Amongst the few techniques that can be used with tracheobronchial injuries, cross field ventilation is a remotely described and rarely used technique, especially in injuries around the carina. We effectively applied cross field ventilation in both our cases and the outcome was excellent.

Lung ultrasound in blunt chest trauma: A clinical review

Ultrasound ◽  
2021 ◽  
pp. 1742271X2199460
Author(s):  
Serena Rovida ◽  
Daniele Orso ◽  
Salman Naeem ◽  
Luigi Vetrugno ◽  
Giovanni Volpicelli
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Lung Ultrasound ◽  
Lung Parenchyma ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Major Life ◽  
Diagnostic Modality ◽  
Life Threatening ◽  
Sternal Fractures

Introduction Bedside lung sonography is recognized as a reliable diagnostic modality in trauma settings due to its ability to detect alterations both in lung parenchyma and in pleural cavities. In severe blunt chest trauma, lung ultrasound can identify promptly life-threatening conditions which may need direct intervention, whereas in minor trauma, lung ultrasound contributes to detection of acute pathologies which are often initially radio-occult and helps in the selection of those patients that might need further investigation. Topic Description We did a literature search on databases EMBASE, PubMed, SCOPUS and Google Scholar using the terms ‘trauma’, ‘lung contusion’, ‘pneumothorax’, ‘hemothorax’ and ‘lung ultrasound’. The latest articles were reviewed and this article was written using the most current and validated information. Discussion Lung ultrasound is quite accurate in diagnosing pneumothorax by using a combination of four sonographic signs; absence of lung sliding, B-lines, lung pulse and presence of lung point. It provides a rapid diagnosis in hemodynamically unstable patients. Lung contusions and hemothorax can be diagnosed and assessed with lung ultrasound. Ultrasound is also very useful for evaluating rib and sternal fractures and for imaging the pericardium for effusion and tamponade. Conclusion Bedside lung ultrasound can lead to rapid and accurate diagnosis of major life-threatening pathologies in blunt chest trauma patients.

Thoracics

2020 ◽  
pp. 215-246
Author(s):  
James Bennett ◽  
Gerard Gould
Keyword(s):  
Best Practice ◽  
Bronchopleural Fistula ◽  
Management Strategies ◽  
Lung Ventilation ◽  
Bronchial Obstruction ◽  
Dynamic Hyperinflation ◽  
One Lung Ventilation ◽  
Cardiac Herniation ◽  
Life Threatening ◽  
Practice Methods

In this chapter on life-threatening thoracic problems in anaesthesia, the authors offer their guidance and expertise on the best-practice methods of dealing with each of these. These problems include tracheal/bronchial obstruction, inhaled foreign body, tracheal injury or laceration, bronchopleural fistula, hypoxia/pneumothorax/high airway pressure during one-lung ventilation, dynamic hyperinflation, cardiac herniation postpneumonectomy, major airway bleeding, and bleeding during mediastinoscopy. In addition, the definitions, presentation, management strategies, investigations, risk factors, exclusions and causes, and any special considerations for each potential thoracically related situation are given and elaborated upon. Lists of up-to-date online resources and further reading are also provided here, offering invaluable know-how to encourage the reader to broaden their knowledge.

Serratus Plane Block Is Effective for Pain Control in Patients With Blunt Chest Trauma: A Case Series

Pain Practice ◽  
2019 ◽  
Vol 20 (2) ◽  
pp. 197-203
Author(s):  
Thibault Martinez ◽  
Thibaut Belveyre ◽  
Alexandre Lopez ◽  
Chloe Dunyach ◽  
Zina Bouzit ◽  
...  
Keyword(s):  
Pain Control ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Case Series

Late Intrathoracic Tracheal Stricture After Blunt Chest Trauma: A Rare Life-Threatening Condition

2016 ◽  
Vol 101 (2) ◽  
pp. 766-769
Author(s):  
Ikram Chaudhry ◽  
Fozan W. Aldulaijan ◽  
Zahra Alhajji ◽  
Ahsan Cheema ◽  
Hadi Mutairi
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Threatening Condition ◽  
Life Threatening ◽  
Tracheal Stricture

scholarly journals Cardiac tamponade as a late complication of a minor trauma due to syncope: A case report and literature review

2018 ◽  
Vol 27 (2) ◽  
pp. 103-106 ◽  
Author(s):  
Matteo Guarino ◽  
Alessandra Bologna ◽  
Alfredo De Giorgi ◽  
Michele D Spampinato ◽  
Christian Molino ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Cardiac Tamponade ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Late Complication ◽  
Minor Trauma ◽  
Threatening Condition ◽  
Life Threatening ◽  
A Minor

Haemopericardium with cardiac tamponade following minor blunt trauma is a rare, life-threatening condition. The diagnosis of cardiac tamponade as well as therapeutic management may be delayed, since the link between trauma and illness is often overlooked. We report the case of an old woman who developed a relatively delayed cardiac tamponade due to an otherwise minor blunt chest trauma following syncope.

scholarly journals Pneumomediastinum and Pneumopericardium in an 11-Year-Old Rugby Player: A Case Report

2013 ◽  
Vol 48 (2) ◽  
pp. 277-281 ◽  
Author(s):  
Valentina Vanzo ◽  
Samuela Bugin ◽  
Deborah Snijders ◽  
Laura Bottecchia ◽  
Veronica Storer ◽  
...  
Keyword(s):  
Emergency Department ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Acute Asthma ◽  
Simultaneous Occurrence ◽  
Trauma Symptoms ◽  
Young Athletes ◽  
Tracheal Rupture ◽  
Acute Asthma Exacerbation ◽  
Life Threatening

Objective: Pneumomediastinum and pneumopericardium are rare occurrences in young athletes, but they can result in potentially life-threatening consequences. Background: While involved in a rugby match, an 11-year-old boy received a chest compression by 3 players during a tackle. He continued to play, but 2 hours later, he developed sharp retrosternal chest pain. A chest radiograph and an echocardiograph at the nearest emergency department showed pneumopericardium and pneumomediastinum. Differential Diagnosis: Sternal and rib contusions, rib fractures, heartburn, acute asthma exacerbation, pneumomediastinum, pneumopericardium, pneumothorax, traumatic tracheal rupture, myocardial infarction, and costochondritis (Tietze syndrome). Treatment: Acetaminophen for pain control. Uniqueness: To our knowledge, this is the only case in the international literature of the simultaneous occurrence of pneumomediastinum and pneumopericardium in a child as a consequence of blunt chest trauma during a rugby match. Conclusions: Pneumomediastinum and pneumopericardium may be consequences of rugby blunt chest trauma. Symptoms can appear 1 to 2 hours later, and the conditions may result in serious complications. Immediate admission to the emergency department is required.

scholarly journals A nationwide survey of intraoperative management for one-lung ventilation in Taiwan: time to accountable for diversity in protective lung ventilation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chuan-Yi Kuo ◽  
Ying-Tung Liu ◽  
Tzu-Shan Chen ◽  
Chen-Fuh Lam ◽  
Ming-Cheng Wu
Keyword(s):  
Clinical Practice ◽  
Practice Guideline ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Ventilator Support ◽  
Lung Protection ◽  
Expert Opinions ◽  
Survey Form ◽  
Thoracic Anesthesia ◽  
Protective Lung Ventilation

Abstract Background There is a major paradigm shift for intraoperative mechanical ventilator support by the introduction of lung protective ventilation strategies to reduce postoperative pulmonary complications and improve overall clinical outcomes in non-thoracic surgeries. However, there is currently a lack of standardized practice guideline for lung protection during thoracic surgeries that require one-lung ventilation (OLV). This study aimed to collect the expert opinions of the thoracic anesthesiologists in perioperative care for OLV surgery in Taiwan. Methods This prospective cross-sectional study was undertaken in 16 tertiary hospitals in Taiwan from January to February 2019. A structured survey form was distributed across the participating hospitals and the thoracic anesthesiologists were invited to complete the form voluntarily. The survey form consisted of three parts, including the basic information of the institutional anesthesia care standards, ventilatory settings for a proposed patient receiving OLV surgery and expert opinions on OLV. Results A total of 71 thoracic anesthesiologists responded to the survey. Double-lumen tubes are the most commonly used (93.8%) airway devices for OLV. The most commonly recommended ventilator setting during OLV is a tidal volume of 6–7 ml/kg PBW (67.6%) and a PEEP level of 4–6 cmH2O (73.5%). Dual controlled ventilator modes are used by 44.1% of the anesthesiologists. During OLV, high oxygen fraction (FiO2 > 0.8) is more commonly supplemented to achieve an oxygen saturation higher than 94%. The consensus of anesthesiologists on the indices for lung protection in thoracic surgery is considerably low. Large majority of the anesthesiologists (91.5%) highly recommend that an international clinical practice guideline on the protective lung ventilation strategy for thoracic anesthesia should be established. Conclusions This study found that the thoracic anesthesiologists in Taiwan share certain common practices in ventilator support during OLV. However, they are concerned about the lack of fundamental clinical evidences to support the beneficial outcomes of the current lung protective strategies applicable to OLV. Large-scale trials are needed to form an evidence-based clinical practice guideline for thoracic anesthesia.

Tracheobronchial injuries after blunt chest trauma in children—Hidden pathology

1998 ◽  
Vol 33 (11) ◽  
pp. 1707-1711 ◽  
Author(s):  
Wendy J Grant ◽  
Rebecka L Meyers ◽  
Richard L Jaffe ◽  
Dale G Johnson
Keyword(s):  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Tracheobronchial Injuries

scholarly journals Anesthetic Challenges in Minimally Invasive Cardiac Surgery

2019 ◽  
Vol 03 (01) ◽  
pp. 28-35
Author(s):  
Uma Balasubramanyam ◽  
Poonam Malhotra Kapoor
Keyword(s):  
New York ◽  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Perioperative Management ◽  
Lung Ventilation ◽  
Minimally Invasive Cardiac Surgery ◽  
Cardiac Anesthesia ◽  
One Lung Ventilation ◽  
Optimal Outcomes ◽  
Thoracic Anesthesia

AbstractThe transition of cardiac surgery away from the traditional sternotomy approach toward more minimally invasive strategies continues to evolve over time. The first minimally invasive cardiac surgery was performed in 2005 in New York by a team led by Dr. Joseph T. McGinn. Anesthesiologists play in a key role in facilitating optimal outcomes in such procedures. Perioperative management of these patients poses specific challenges to the anesthesia team. The anesthesiologist must be skilled in numerous subspecialty skillsets including regional anesthesia and analgesia techniques, and elements of thoracic anesthesia practice, in particular one-lung ventilation (OLV), cardiac anesthesia, and transesophageal echocardiography.

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