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Iatrogenic tracheobronchial and chest injury
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Marios Froudarakis, Demosthenes Makris, Demosthenes Bouros
In the setting of haemothorax the main therapeutic options are chest tube placement, thoracoscopy or video-assisted thoracic surgery and early or late thoracostomy. Pleural drainage allows removal of the blood with monitoring of blood loss and can be helpful to decide whether further surgical interventions are necessary. Rapid loss of 1–2 L of blood or ongoing blood loss of exceeding 200 mL/h through a chest tube is an indication for thoracostomy. In cases of severe blood loss, enough blood is matched and general measures for resuscitation are required to correct hypovolaemia and to support an unstable patient.
Effect of geometrical and mechanical parameters of ribs submitted to high velocity impact. A numerical investigation
Published in Mechanics of Advanced Materials and Structures, 2022
Thoracic injuries happen frequently in various frameworks of impact biomechanics such as automotive industries, sports and high-velocity ballistic impacts, second fatal injury behind head injury [1–5]. Rib fractures are common in thoracic injuries that can lead to life-threatening injuries, such as bone fragments of ribs perforating the lung pleural surface, lung parenchyma, liver or heart, which may result in pneumothorax, hemothorax or death [6, 7]. Specifically, the elderly who are more likely to encounter rib fractures, they need longer recovery time or even face higher mortality owe to the decreased thoracic injury tolerance [8, 9]. In consequence, it is of importance to investigate the dynamic responses of ribs under dynamic loadings, which can help understand the mechanisms of rib fractures and corresponding injury criterion.
Outcomes after mechanical versus manual chest compressions in eCPR patients
Published in Expert Review of Medical Devices, 2021
Christopher Gaisendrees, Stephen Gerfer, Borko Ivanov, Anton Sabashnikov, Julia Merkle, Maximilian Luehr, Georg Schlachtenberger, Sebastian G Walter, Kaveh Eghbalzadeh, Elmar Kuhn, Ilija Djordjevic, Thorsten Wahlers
Even though CPR-related injuries are significantly more common after mechanical reanimation devices, overall mortality did not significantly differ between the groups. This is mainly due to the differences mentioned above in low-flow time and prognostic factors, such as initial heart rhythm. Besides the occurrence of injuries, it seems vital to detect and treat these arrhythmias accordingly. A routine full-body CT scan directly after hemodynamic stabilization by eCPR followed by cardiac revascularization (if necessary) might be the most crucial step in diagnostics for these patients. In a full-body CT-scan study of 103 eCPR patients, 6.5 pathological findings could be demonstrated on average in each patient, namely rib fractures and pneumo- or hemothorax [9]. In our study, 55% of patients with cCPR before ECMO cannulation and 83% of patients after mCPR showed relevant injuries; these numbers may even be underestimated as not all patients received full-body imaging directly after eCPR. In summary, clinicians should perform an extensive search for injuries and hemorrhagic complications after eCPR.
An evaluation methodology for motorcyclists’ wearable airbag protectors based on finite element simulations
Published in International Journal of Crashworthiness, 2021
Oscar Cherta Ballester, Maxime Llari, Valentin Honoré, Catherine Masson, Pierre-Jean Arnoux
As for the rib cage, the use of the airbag protector reduces the risk of soft tissue injuries for all simulated impacts. The computed probabilities of sustaining severe injuries ranged from 1 to 63%. The likelihood of sustaining a severe soft tissue injury to the chest was below 25%, except for high velocity impacts (9 m/s) with the kerbstone and pillar impactors. A maximum reduction of 22% of the probability of getting severely injured was observed for the impact with the kerbstone impactor at 7 m/s. The risk of a severe injury being sustained was practically avoided (<15%) for impacts with the plate and pillar impactors at 5 and 7 m/s and for the impact with the kerbstone impactor at 5 m/s. Considering the main severe thoracic soft tissue injuries (AIS > 3) sustained by motorcyclists in real-world accidents [4], the airbag protector allows reducing the probability of sustaining severe lung contusions and lacerations, hemothorax and pneumothorax.