Department of Thoracic Surgery, Fundación Valle del Lili, Kra 98 No. 18-49, Cali, 760032, Colombia.
Department of Cardiovascular Surgery, Fundación Valle del Lili, Kra 98 No. 18-49, Cali, Colombia.
J Cardiothorac Surg. 2024 Jul 15;19(1):445. doi: 10.1186/s13019-024-02862-0.
Penetrating thoracic injuries have a significant risk of morbi-mortality. Despite the advancements in damage control methods, a subset of patients with severe pulmonary vascular lesions and bronchial injuries persists. In some of these cases, post-traumatic pneumonectomy is required, and perioperative extracorporeal membrane oxygenation (ECMO) support may be required due to right ventricular failure and respiratory failure.
A male was brought to the emergency department (ED) with a penetrating thoracic injury, presenting with massive right hemothorax and active bleeding that required ligation of the right pulmonary hilum to control the bleeding. Subsequently, he developed right ventricular dysfunction and ARDS, necessitating a dynamic hybrid ECMO configuration to support his condition and facilitate recovery.
Penetrating thoracic injuries with severe pulmonary vascular lesions may need pneumonectomy to control bleeding. ECMO support reduces the associated mortality by decreasing the complications rate. A multidisciplinary team is essential to achieve good outcomes in severe compromised patients.
穿透性胸部损伤有很高的病死率。尽管损伤控制方法有所进步，但仍有一部分患者存在严重的肺血管损伤和支气管损伤。在某些情况下，需要进行创伤后肺切除术，由于右心室衰竭和呼吸衰竭，可能需要体外膜氧合（ECMO）支持。
一名男性因穿透性胸部损伤被送往急诊部，表现为大量右侧血胸和活动性出血，需要结扎右肺门以控制出血。随后，他出现右心室功能障碍和 ARDS，需要动态杂交 ECMO 配置来支持他的病情并促进恢复。
严重肺血管损伤的穿透性胸部损伤可能需要肺切除术来控制出血。ECMO 支持通过降低并发症发生率来降低相关死亡率。多学科团队对于严重受损患者获得良好结果至关重要。
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