The Experts below are selected from a list of 213 Experts worldwide ranked by ideXlab platform
Hiroshi Inoue - One of the best experts on this subject based on the ideXlab platform.
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Diagnosis and Treatment of Deep Pulmonary Laceration With Intrathoracic Hemorrhage From Blunt Trauma
The Annals of thoracic surgery, 2010Co-Authors: Noboru Nishiumi, Sadaki Inokuchi, Kana Oiwa, Ryouta Masuda, Masayuki Iwazaki, Hiroshi InoueAbstract:Background Blunt chest trauma resulting in massive hemothorax requires immediate attention. We investigated the diagnostic and prognostic utility of various clinical factors in patients with deep Pulmonary Laceration caused by blunt chest trauma with a view toward interventional treatment. Methods We reviewed 42 patients with deep Pulmonary Laceration resulting from blunt chest trauma who were treated between 1988 and 2008. Various clinical factors were compared between survivors and nonsurvivors. Results Of the 42 patients, 29 (69%) survived. Median (25th, 75th percentile) systolic blood pressure at arrival was 102 (76, 121) mm Hg for survivors and 70 (60, 90) mm Hg for nonsurvivors (p = 0.015). The median heart rate at arrival was 107 (98, 120) beats/min for survivors and 130 (120, 140) beats/min for nonsurvivors (p = 0.014). Respiratory rate, Glasgow Coma Scale score, and arterial blood gas values did not affect prognosis. Blood loss through the chest tube at insertion was 500 (400, 700) mL for survivors and 700 (500, 1000) mL for nonsurvivors (p = 0.147) and within 2 hours of arrival was 850 (590, 1100) mm Hg and 1600 (1400, 2000) mL, respectively (p Conclusions In patients with deep Pulmonary Laceration, hemorrhagic shock with systolic blood pressure less than 80 mm Hg and heart rate more than 120 beats/min leads to a poor prognosis. Emergency thoracotomy and Pulmonary lobectomy should be performed before the intrathoracic hemorrhage reaches 1200 mL.
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A case of deep Pulmonary Laceration associated with blunt chest trauma treated by emergency room thoracotomy.
The Tokai journal of experimental and clinical medicine, 2007Co-Authors: Ryota Masuda, Masayuki Iwazaki, Tomoki Nakagawa, Atsushi Hamamoto, Yoshimasa Inoue, Hiroshi InoueAbstract:A 30-year-old man fell from the fourth floor of a building and suffered a chest injury. He was transported to our hospital within 50 minutes. Chest roentgenography showed left hemopneumothorax and a shift of the mediastinal shadow to the right. Furthermore, most of the left upper lobe did not appear collapsed, and an infiltrative shadow and light macular shadows were noted. These findings led to a diagnosis of deep Pulmonary Laceration. The volume of blood in the left drainage tube reached about 1,000 mL within 1 hour. Therefore, we performed emergency room thoracotomy (ERT) and clamped the Pulmonary hilum manually. We then moved him to an operating room. Upon surgery, we found extensive Laceration of the whole lung, and left pneumonectomy was necessary. He was discharged on hospital day 58. ERT and Pulmonary hilum clamping may improve the survival of patients with deep Pulmonary Laceration and uncontrollable pleural hemorrhage.
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Life-saving treatment by fluid resuscitation and a thoracotomy in a case of deep Pulmonary Laceration.
The Tokai journal of experimental and clinical medicine, 2006Co-Authors: Noboru Nishiumi, Sadaki Inokuchi, Masayuki Iwasaki, Haruka Takeichi, Hiroyuki Otsuka, Hiroshi InoueAbstract:CASE A 41-year-old man survived deep Pulmonary and hepatic Lacerations by treatment with fluid resuscitation, blood transfusion, thoracotomy, and transcatheter hepatic artery embolization. The patient was transferred to our hospital 46 minutes after his motorbike struck a station wagon from behind. Hemorrhagic shock with systolic blood pressure of 68 mmHg was observed. He showed nonresponse to 20-minute intravenous infusion of 1,500 mL of lactated Ringer's solution. The initial plain chest radiograph showed mediastinal deviation to the left, radio-opacity of the right lower lobe, and decreased radiolucency of the right thorax. Rapid drainage of 800 mL of blood through a right chest tube led to a diagnosis of a deep Pulmonary Laceration of the right lower lobe. Abdominal computed tomography revealed another deep Laceration affecting 40% of the liver. A right lower lobectomy of the lung was performed at 169 minutes after arrival. After the thoracotomy,transcatheter arterial embolization of the right hepatic artery was performed. The patient was discharged on hospital day 57. CONCLUSION Prompt diagnosis and appropriate treatment are necessary to save patients with multiple, severe blunt injuries. Advanced Trauma Life Support (ATLS) guidelines should be adhered to for appropriate early treatment of patients with severe trauma.
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Blunt chest trauma with deep Pulmonary Laceration.
The Annals of thoracic surgery, 2001Co-Authors: Noboru Nishiumi, Fumio Maitani, Toyohiko Tsurumi, Kichizo Kaga, Masayuki Iwasaki, Hiroshi InoueAbstract:Abstract Background . Deep Pulmonary Laceration (DPL) is rare and its survival rate is low. The present study focused on the prognostic factors of DPL. Methods . The present study concerned 17 DPL patients treated in Tokai University Hospital between 1988 and 1998. The prognostic factors of DPL were compared with systolic blood pressure (SBP), PaO 2 , and the volume of intrathoracic blood loss. Characteristic findings of initial chest roentgenograms of DPL were investigated. Results . Eleven patients were saved and 6 patients died. An SBP of less than 80 mm Hg on arrival at the hospital and a blood loss of more than 1,000 mL through the chest tube within 2 hours after arrival were poor prognostic factors. Hypoxemia on arrival was not a poor prognostic factor. Chest roentgenograms showed macular infiltrative shadow with moderate lung collapse and deviation of the mediastinal shadow toward the unaffected side. Selective bronchial occlusion with a Univent prevented suffocation by intrabronchial blood. Conclusions . Two poor prognostic factors of DPL are SBP less than 80 mm Hg on arrival and blood loss of more than 1,000 mL through the chest tube within 2 hours after arrival.
Kong Ling-we - One of the best experts on this subject based on the ideXlab platform.
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Strategies for the treatment of traumatic pneumatocele
Journal of Traumatic Surgery, 2014Co-Authors: Kong Ling-weAbstract:Traumatic pneumatocele is a type of deep Pulmonary Laceration. Computed tomography is a sensitive method for early detection of the lesion. Traumatic pneumatocele occurs primarily in children and young adults,which also occurs more in adults. Most of these patients need only conservative treatment. Surgical treatment is indicated in rare instances and only when complications occur.
J Škorpil - One of the best experts on this subject based on the ideXlab platform.
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Penetrating chest trauma - experience of the Pilsen University Hospital Trauma Centre
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2017Co-Authors: J Vodička, V Špidlen, V Třeška, Š Vejvodová, A Židková, Doležal J, J ŠkorpilAbstract:INTRODUCTION:Retrospective analysis of a set of patients treated for penetrating chest trauma in the Trauma Centre at University Hospital Pilsen over seventeen years. METHOD:Overall, 96 injured with penetrating chest trauma were treated in the study period 2000-2016. Basic demographics, the mechanism, type, location and extent of the penetrating chest trauma, Injury Severity Score, existence of associated injuries, diagnostic procedures, timing and method of the chest trauma treatment as well as any complications and reoperations were identified in the set. Other collected information included deaths of the injured, and the cause and time of death in relation to the time of admission to the Trauma Centre. RESULTS:The most common mechanism of injury was attack by a stabbing weapon (54%) and the most common type of injury was Pulmonary Laceration (33%). The average Injury Severity Score within the set was 24 points. The most common therapeutic procedure was pleural cavity drainage (47 patients), and less than 40% of the cases required revision surgery by means of thoracotomy or sternotomy. One patient died immediately after being admitted to the Trauma Centre without a chance to apply any therapy; three other patients died during resuscitative thoracotomy or laparotomy. Post-operative complications occurred in 13 patients (13.5%) and required 14 reoperations. CONCLUSIONS:The diagnostic and therapeutic algorithm of penetrating chest trauma is primarily determined by the condition of the injured. Adequate drainage of the relevant pleural cavity is sufficient to treat one half of the patients; on the other hand, 40% of traumas, injuries of the heart, large vessels and gunshot wounds in particular, require urgent revision surgery by means of thoracotomy or sternotomy. If the injured patient is transported to a specialized centre for timely treatment, the prognosis of penetrating chest traumas is quite favourable.Key words: penetrating chest trauma - diagnosis - chest drainage - thoracotomy - sternotomy.
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Penetrating chest trauma - experience of the Pilsen University Hospital Trauma Centre
Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti, 1Co-Authors: J Vodička, V Špidlen, V Třeška, Š Vejvodová, J Doležal, A Židková, J ŠkorpilAbstract:Retrospective analysis of a set of patients treated for penetrating chest trauma in the Trauma Centre at University Hospital Pilsen over seventeen years. Overall, 96 injured with penetrating chest trauma were treated in the study period 2000-2016. Basic demographics, the mechanism, type, location and extent of the penetrating chest trauma, Injury Severity Score, existence of associated injuries, diagnostic procedures, timing and method of the chest trauma treatment as well as any complications and reoperations were identified in the set. Other collected information included deaths of the injured, and the cause and time of death in relation to the time of admission to the Trauma Centre. The most common mechanism of injury was attack by a stabbing weapon (54%) and the most common type of injury was Pulmonary Laceration (33%). The average Injury Severity Score within the set was 24 points. The most common therapeutic procedure was pleural cavity drainage (47 patients), and less than 40% of the cases required revision surgery by means of thoracotomy or sternotomy. One patient died immediately after being admitted to the Trauma Centre without a chance to apply any therapy; three other patients died during resuscitative thoracotomy or laparotomy. Post-operative complications occurred in 13 patients (13.5%) and required 14 reoperations. The diagnostic and therapeutic algorithm of penetrating chest trauma is primarily determined by the condition of the injured. Adequate drainage of the relevant pleural cavity is sufficient to treat one half of the patients; on the other hand, 40% of traumas, injuries of the heart, large vessels and gunshot wounds in particular, require urgent revision surgery by means of thoracotomy or sternotomy. If the injured patient is transported to a specialized centre for timely treatment, the prognosis of penetrating chest traumas is quite favourable.Key words: penetrating chest trauma - diagnosis - chest drainage - thoracotomy - sternotomy.
Noboru Nishiumi - One of the best experts on this subject based on the ideXlab platform.
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Diagnosis and Treatment of Deep Pulmonary Laceration With Intrathoracic Hemorrhage From Blunt Trauma
The Annals of thoracic surgery, 2010Co-Authors: Noboru Nishiumi, Sadaki Inokuchi, Kana Oiwa, Ryouta Masuda, Masayuki Iwazaki, Hiroshi InoueAbstract:Background Blunt chest trauma resulting in massive hemothorax requires immediate attention. We investigated the diagnostic and prognostic utility of various clinical factors in patients with deep Pulmonary Laceration caused by blunt chest trauma with a view toward interventional treatment. Methods We reviewed 42 patients with deep Pulmonary Laceration resulting from blunt chest trauma who were treated between 1988 and 2008. Various clinical factors were compared between survivors and nonsurvivors. Results Of the 42 patients, 29 (69%) survived. Median (25th, 75th percentile) systolic blood pressure at arrival was 102 (76, 121) mm Hg for survivors and 70 (60, 90) mm Hg for nonsurvivors (p = 0.015). The median heart rate at arrival was 107 (98, 120) beats/min for survivors and 130 (120, 140) beats/min for nonsurvivors (p = 0.014). Respiratory rate, Glasgow Coma Scale score, and arterial blood gas values did not affect prognosis. Blood loss through the chest tube at insertion was 500 (400, 700) mL for survivors and 700 (500, 1000) mL for nonsurvivors (p = 0.147) and within 2 hours of arrival was 850 (590, 1100) mm Hg and 1600 (1400, 2000) mL, respectively (p Conclusions In patients with deep Pulmonary Laceration, hemorrhagic shock with systolic blood pressure less than 80 mm Hg and heart rate more than 120 beats/min leads to a poor prognosis. Emergency thoracotomy and Pulmonary lobectomy should be performed before the intrathoracic hemorrhage reaches 1200 mL.
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Life-saving treatment by fluid resuscitation and a thoracotomy in a case of deep Pulmonary Laceration.
The Tokai journal of experimental and clinical medicine, 2006Co-Authors: Noboru Nishiumi, Sadaki Inokuchi, Masayuki Iwasaki, Haruka Takeichi, Hiroyuki Otsuka, Hiroshi InoueAbstract:CASE A 41-year-old man survived deep Pulmonary and hepatic Lacerations by treatment with fluid resuscitation, blood transfusion, thoracotomy, and transcatheter hepatic artery embolization. The patient was transferred to our hospital 46 minutes after his motorbike struck a station wagon from behind. Hemorrhagic shock with systolic blood pressure of 68 mmHg was observed. He showed nonresponse to 20-minute intravenous infusion of 1,500 mL of lactated Ringer's solution. The initial plain chest radiograph showed mediastinal deviation to the left, radio-opacity of the right lower lobe, and decreased radiolucency of the right thorax. Rapid drainage of 800 mL of blood through a right chest tube led to a diagnosis of a deep Pulmonary Laceration of the right lower lobe. Abdominal computed tomography revealed another deep Laceration affecting 40% of the liver. A right lower lobectomy of the lung was performed at 169 minutes after arrival. After the thoracotomy,transcatheter arterial embolization of the right hepatic artery was performed. The patient was discharged on hospital day 57. CONCLUSION Prompt diagnosis and appropriate treatment are necessary to save patients with multiple, severe blunt injuries. Advanced Trauma Life Support (ATLS) guidelines should be adhered to for appropriate early treatment of patients with severe trauma.
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Blunt chest trauma with deep Pulmonary Laceration.
The Annals of thoracic surgery, 2001Co-Authors: Noboru Nishiumi, Fumio Maitani, Toyohiko Tsurumi, Kichizo Kaga, Masayuki Iwasaki, Hiroshi InoueAbstract:Abstract Background . Deep Pulmonary Laceration (DPL) is rare and its survival rate is low. The present study focused on the prognostic factors of DPL. Methods . The present study concerned 17 DPL patients treated in Tokai University Hospital between 1988 and 1998. The prognostic factors of DPL were compared with systolic blood pressure (SBP), PaO 2 , and the volume of intrathoracic blood loss. Characteristic findings of initial chest roentgenograms of DPL were investigated. Results . Eleven patients were saved and 6 patients died. An SBP of less than 80 mm Hg on arrival at the hospital and a blood loss of more than 1,000 mL through the chest tube within 2 hours after arrival were poor prognostic factors. Hypoxemia on arrival was not a poor prognostic factor. Chest roentgenograms showed macular infiltrative shadow with moderate lung collapse and deviation of the mediastinal shadow toward the unaffected side. Selective bronchial occlusion with a Univent prevented suffocation by intrabronchial blood. Conclusions . Two poor prognostic factors of DPL are SBP less than 80 mm Hg on arrival and blood loss of more than 1,000 mL through the chest tube within 2 hours after arrival.
J Vodička - One of the best experts on this subject based on the ideXlab platform.
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Penetrating chest trauma - experience of the Pilsen University Hospital Trauma Centre
Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti, 2017Co-Authors: J Vodička, V Špidlen, V Třeška, Š Vejvodová, A Židková, Doležal J, J ŠkorpilAbstract:INTRODUCTION:Retrospective analysis of a set of patients treated for penetrating chest trauma in the Trauma Centre at University Hospital Pilsen over seventeen years. METHOD:Overall, 96 injured with penetrating chest trauma were treated in the study period 2000-2016. Basic demographics, the mechanism, type, location and extent of the penetrating chest trauma, Injury Severity Score, existence of associated injuries, diagnostic procedures, timing and method of the chest trauma treatment as well as any complications and reoperations were identified in the set. Other collected information included deaths of the injured, and the cause and time of death in relation to the time of admission to the Trauma Centre. RESULTS:The most common mechanism of injury was attack by a stabbing weapon (54%) and the most common type of injury was Pulmonary Laceration (33%). The average Injury Severity Score within the set was 24 points. The most common therapeutic procedure was pleural cavity drainage (47 patients), and less than 40% of the cases required revision surgery by means of thoracotomy or sternotomy. One patient died immediately after being admitted to the Trauma Centre without a chance to apply any therapy; three other patients died during resuscitative thoracotomy or laparotomy. Post-operative complications occurred in 13 patients (13.5%) and required 14 reoperations. CONCLUSIONS:The diagnostic and therapeutic algorithm of penetrating chest trauma is primarily determined by the condition of the injured. Adequate drainage of the relevant pleural cavity is sufficient to treat one half of the patients; on the other hand, 40% of traumas, injuries of the heart, large vessels and gunshot wounds in particular, require urgent revision surgery by means of thoracotomy or sternotomy. If the injured patient is transported to a specialized centre for timely treatment, the prognosis of penetrating chest traumas is quite favourable.Key words: penetrating chest trauma - diagnosis - chest drainage - thoracotomy - sternotomy.
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Penetrating chest trauma - experience of the Pilsen University Hospital Trauma Centre
Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti, 1Co-Authors: J Vodička, V Špidlen, V Třeška, Š Vejvodová, J Doležal, A Židková, J ŠkorpilAbstract:Retrospective analysis of a set of patients treated for penetrating chest trauma in the Trauma Centre at University Hospital Pilsen over seventeen years. Overall, 96 injured with penetrating chest trauma were treated in the study period 2000-2016. Basic demographics, the mechanism, type, location and extent of the penetrating chest trauma, Injury Severity Score, existence of associated injuries, diagnostic procedures, timing and method of the chest trauma treatment as well as any complications and reoperations were identified in the set. Other collected information included deaths of the injured, and the cause and time of death in relation to the time of admission to the Trauma Centre. The most common mechanism of injury was attack by a stabbing weapon (54%) and the most common type of injury was Pulmonary Laceration (33%). The average Injury Severity Score within the set was 24 points. The most common therapeutic procedure was pleural cavity drainage (47 patients), and less than 40% of the cases required revision surgery by means of thoracotomy or sternotomy. One patient died immediately after being admitted to the Trauma Centre without a chance to apply any therapy; three other patients died during resuscitative thoracotomy or laparotomy. Post-operative complications occurred in 13 patients (13.5%) and required 14 reoperations. The diagnostic and therapeutic algorithm of penetrating chest trauma is primarily determined by the condition of the injured. Adequate drainage of the relevant pleural cavity is sufficient to treat one half of the patients; on the other hand, 40% of traumas, injuries of the heart, large vessels and gunshot wounds in particular, require urgent revision surgery by means of thoracotomy or sternotomy. If the injured patient is transported to a specialized centre for timely treatment, the prognosis of penetrating chest traumas is quite favourable.Key words: penetrating chest trauma - diagnosis - chest drainage - thoracotomy - sternotomy.
