Hamad Medical Corporation, Trauma Surgery, Doha, Qatar.
Ambulance Service Group & Clinical Governance, Hamad Medical Corporation, Qatar.
J Investig Med High Impact Case Rep. 2023 Jan-Dec;11:23247096231211063. doi: 10.1177/23247096231211063.
Tension pneumothorax (TPX) is a severe chest complication of blunt or penetrating trauma. Immediate decompression is the lifesaving action in patients with TPX. Needle decompression (ND) is frequently used for this purpose, particularly in limited resources setting such as the prehospital arena. Despite the safe profile, the blind nature of the procedure can result in a serious range of complications, including injury to the vital intrathoracic structures such as the lungs, great vessels, and heart. Here, we reported 2 cases of blunt chest trauma resulting in TPX demanding immediate ND; however, nonintentional pericardial and pulmonary artery injuries occurred. The first case was a 42-year-old man with a needle-related pulmonary artery injury that required surgery. The second case was a 19-year-old man in whom a needle-related pneumopericardium occurred and was treated conservatively. In both cases, trained personnel performed the ND. Although ND in the field is a lifesaving intervention, it may further complicate the patient condition. Therefore, it should be performed in adherence to the universal guidelines.
张力性气胸（TPX）是钝性或穿透性创伤的严重胸部并发症。对于 TPX 患者，立即减压是救命的措施。为此目的，经常使用针式减压（ND），尤其是在院前等资源有限的环境中。尽管 ND 具有安全的特点，但该操作的盲目性可能导致一系列严重的并发症，包括对肺、大血管和心脏等重要的胸腔内结构的损伤。在这里，我们报告了 2 例因钝性胸部创伤导致需要立即进行 ND 的 TPX 患者，但发生了非故意的心包和肺动脉损伤。第 1 例是 42 岁的男性，因针相关的肺动脉损伤需要手术治疗。第 2 例是 19 岁的男性，发生了针相关的心包积气，采用保守治疗。在这两例中，均由经过培训的人员进行 ND。尽管现场的 ND 是一种救生干预措施，但它可能会进一步使患者的病情复杂化。因此，应遵循通用指南进行操作。
