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World Journal of Surgery

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01-06-2019 | Thoracotomy

Sign of Life is Associated with Return of Spontaneous Circulation After Resuscitative Thoracotomy: Single Trauma Center Experience of Republic of Korea

Authors: Byung Hee Kang, Donghwan Choi, Yo Huh, Junsik Kwon, Kyoungwon Jung, John Cook-Jong Lee, Jonghwan Moon

Published in: World Journal of Surgery | Issue 6/2019

Abstract

Background

Resuscitative thoracotomy (RT) can be a lifesaving treatment, but it has not yet been performed in Korea. In this study, we review our experience of RT after a regional trauma center was constructed.

Methods

This is a retrospective study of RT conducted at a single Korean trauma center from May 2014 to March 2018. The primary outcome was survival, and the secondary outcome was return of spontaneous circulation (ROSC). The clinical characteristics of the patients were compared between the ROSC and non-ROSC groups. Survivors were also reviewed.

Results

A total of 62 patients were reviewed, and 60 patients had experienced blunt injury. Thirty-nine patients had ROSC. The ROSC group had short cardiopulmonary resuscitation (CPR) time (6 [2–10] min vs 11 [8–12] min, p < 0.001), the presence of sign of life at the trauma bay [32 (86.5%) vs 7 (28.0%), p < 0.001], and a low Injury Severity Score [26 (25–39) vs 37 (30–75), p = 0.038] compared to the non-ROSC group. On multivariate analysis, only the presence of sign of life was significantly associated with ROSC [11.297 (1.496–85.309) OR (95% CI), p = 0.019]. The 24-h survival rate was 8.1%, and the successful discharge rate was 4.8%.

Conclusion

The outcome of RT in a Korean trauma center was favorable. ROSC after RT was strongly associated with the presence of sign of life, and RT may be performed in the presence of sign of life regardless of prehospital CPR time.

Moore EE, Feliciano DV, Trauma Mattox KL (2017) In: Tsai PI, Wall JM Jr, Mattox KL (eds) Trauma thoracotomy: general principles and techniques. McGraw-Hill education, New York, pp 473–478

Pust GD, Namias N (2016) Resuscitative thoracotomy. Int J Surg 33:202–208CrossRefPubMed

Moore HB, Moore EE, Burlew CC et al (2016) Establishing benchmarks for resuscitation of traumatic circulatory arrest: success-to-rescue and survival among 1,708 patients. J Am Coll Surg 223:42–50CrossRefPubMedPubMedCentral

Hong J, Lee WK, Park H (2006) Change in causes of injury-related deaths in South Korea, 1996–2006. J Epidemiol 21:500–506CrossRef

Park JM (2016) Outcomes of the support services for the establishment of regional level 1 trauma centers. J Korean Med Assoc 59:920–930

Aso S, Matsui H, Fushimi K et al (2017) Resuscitative endovascular balloon occlusion of the aorta or resuscitative thoracotomy with aortic clamping for noncompressible torso hemorrhage: a retrospective nationwide study. J Trauma Acute Care Surg 82:910–914CrossRefPubMed

Moriwaki Y, Sugiyama M, Yamamoto T et al (2011) Outcomes from prehospital cardiac arrest in blunt trauma patients. World J Surg 35:34–42. https://doi.org/10.1007/s00268-010-0798-4 CrossRefPubMed

Suzuki K, Inoue S, Morita S et al (2016) Comparative Effectiveness of emergency resuscitative thoracotomy versus closed chest compressions among patients with critical blunt trauma. A nationwide cohort study in Japan. PLoS One 11:e0145963CrossRefPubMedPubMedCentral

Burlew CC, Moore EE, Moore FA et al (2012) Western Trauma Association critical decisions in trauma: resuscitative thoracotomy. J Trauma Acute Care Surg 73:1359–1363CrossRefPubMed

10.

Seamon MJ, Haut ER, Van Arendonk K et al (2015) An evidence-based approach to patient selection for emergency department thoracotomy: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg 79:159–173CrossRefPubMed

11.

Jung KW, Huh Y, Lee JC et al (2016) Reduced mortality by physician-staffed HEMS dispatch for adult blunt trauma patients in Korea. J Korean Med Sci 31:1656–1661CrossRefPubMedPubMedCentral

12.

Owen JJ, Sne N, Coates A et al (2015) Outcomes of emergency department thoracotomy in a tertiary care Canadian trauma centre. CJEM 17:353–358CrossRefPubMed

13.

Rhee PM, Acosta J, Bridgeman A et al (2000) Survival after emergency department thoracotomy: review of published data from the past 25 years. J Am Coll Surg 190:288–298CrossRefPubMed

14.

Slessor D, Hunter S (2015) To be blunt: are we wasting our time? Emergency department thoracotomy following blunt trauma: a systematic review and meta-analysis. Ann Emerg Med 65(297–307):e216

15.

Kim J, Heo Y, Lee JC et al (2015) Effective transport for trauma patients under current circumstances in Korea: a single institution analysis of treatment outcomes for trauma patients transported via the domestic 119 service. J Korean Med Sci 30:336–342CrossRefPubMedPubMedCentral

16.

Passos EM, Engels PT, Doyle JD et al (2012) Societal costs of inappropriate emergency department thoracotomy. J Am Coll Surg 214:18–25CrossRefPubMed

17.

Millin MG, Galvagno SM, Khandker SR et al (2013) Standards. Withholding and termination of resuscitation of adult cardiopulmonary arrest secondary to trauma: resource document to the joint NAEMSP-ACSCOT position statements. J Trauma Acute Care Surg 75:459–467CrossRefPubMed

18.

Matsumoto H, Mashiko K, Hara Y et al (2009) Role of resuscitative emergency field thoracotomy in the Japanese helicopter emergency medical service system. Resuscitation 80:1270–1274CrossRefPubMed

19.

Alarhayem AQ, Myers JG, Dent D et al (2016) Time is the enemy: mortality in trauma patients with hemorrhage from torso injury occurs long before the “golden hour”. Am J Surg 212:1101–1105CrossRefPubMed

Title: Sign of Life is Associated with Return of Spontaneous Circulation After Resuscitative Thoracotomy: Single Trauma Center Experience of Republic of Korea
Authors: Byung Hee Kang
Donghwan Choi
Yo Huh
Junsik Kwon
Kyoungwon Jung
John Cook-Jong Lee
Jonghwan Moon
Publication date: 01-06-2019
Publisher: Springer International Publishing
Keywords: Thoracotomy
Cardiopulmonary Resuscitation
Published in: World Journal of Surgery / Issue 6/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-04939-7

At a glance: The STEP trials

Springer Medicine

Sign of Life is Associated with Return of Spontaneous Circulation After Resuscitative Thoracotomy: Single Trauma Center Experience of Republic of Korea

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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