Resuscitative thoracotomy
Resuscitative thoracotomy is a surgical procedure performed in emergency situations to gain access to the heart and lungs. It is typically performed in cases of severe chest trauma, cardiac arrest, or other life-threatening conditions where immediate intervention is required to save the patient's life.
Indications
Resuscitative thoracotomy is indicated in cases of penetrating chest trauma, blunt chest trauma, and traumatic cardiac arrest. It is also used in cases of non-traumatic cardiac arrest when conventional resuscitation efforts have failed. The procedure is typically performed in the emergency department or in the pre-hospital setting by trained emergency medical personnel.
Procedure
The procedure involves making a large incision in the chest wall to expose the heart and lungs. The pericardium, the sac that encloses the heart, is then opened to relieve pressure and allow for direct cardiac massage. In cases of lung injury, the procedure can also allow for the removal of blood or air from the pleural space.
Risks and Complications
As with any surgical procedure, there are risks associated with resuscitative thoracotomy. These include infection, bleeding, damage to surrounding organs, and potential long-term complications such as lung dysfunction. Despite these risks, the procedure is often the only chance of survival for patients in critical condition.
Outcomes
The success of a resuscitative thoracotomy is highly dependent on the cause of the patient's condition and the timing of the procedure. In general, the procedure has a higher success rate in cases of penetrating trauma compared to blunt trauma.
See Also
Resuscitative_thoracotomy
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Contributors: Prab R. Tumpati, MD