Scandinavian journal of thoracic and cardiovascular surgery
-
Five hundred and eleven patients with penetrating or perforating chest injuries were admitted to the Department of Thoracic and Cardiovascular Surgery, University Central Hospital, Helsinki, during the 25-year-period 1952-77. There were 433 stab wounds, 59 gunshot wounds and 19 other penetrating injuries. The organs most often involved were lungs (major haemo- or pneumothorax in 385 patients), heart (63 patients) and liver (61 patients). ⋯ One of them had an aortopulmonary fistula and the other a traumatic VSD combined with aortic valve lesion. One of the traumatic VSDs closed spontaneously during the follow-up time. An active operative approach in the early phase seems to guarantee the best final results, especially in the most critically ill patients.
-
Scand J Thorac Cardiovasc Surg · Jan 1981
Plasma colloid osmotic pressure during open-heart surgery using non-colloid or colloid priming solution in the extracorporeal circuit.
Two different priming solutions for the heart-lung machine were compared in 14 patients during aortic valve replacement. Colloid osmotic pressure (COP), and albumin in plasma, blood erythrocyte volume fraction (B-EVF) and arterial oxygen tension (PaO2) (FIO2 = 1.0) were followed before, during and after perfusion. The two priming solutions were 2,000 ml Ringerdex (7 patients) or 1,800 ml Ringerdex + 200 ml 20% albumin (7 patients). ⋯ There was a good correlation between COP and albumin measured in the same plasma samples (r = 0.83, p less than 0.001). At one hour after bypass PaO2 (FIO2 = 1.0) tended to decrease in the non-colloid group, compared with preperfusion level. 40 g of albumin was a too small amount of colloid to diminish substantially the reduction of COP during perfusion. The unchanged levels of COP and B-EVF during perfusion, despite further dilution as well as the parallel normalization after perfusion, can only be explained by loss of water from the circulation.
-
An analysis of 337 wilfully inflicted penetrating thoracic injuries is made. In 22 cases thoracotomy was performed; in 19 cases laparotomy was indicated, ten times for direct trauma and nine times for lesions caused by abdominal stabbing in addition to penetrating thoracic injuries. Eight patients died, one of whom was not operated on. A necrology is presented and it is also concluded from the recent literature that a more aggressive approach, e.g. immediate operation, is indicated for serious penetrating thoracic trauma.