Desempenho e desfecho das toracotomias de reanimação realizadas em um centro de trauma sul-brasileiro: análise retrospectiva de 7 anos.

• Autor(a) principal: Yamashita, Eduardo Massaro
• Data de Publicação: 2021
• Outros Autores: Franco, Giorgia Souza, Arakaki, Isabella Kohatsu, Amado, Wellidha Bianca Rocha
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório do Centro Universitário Braz Cubas
• Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/3843
• topic: Toracotomia; Ferimentos e lesões; Procedimentos Cirúrgicos torácicos; Índices de gravidade do trauma; CNPQ::CIENCIAS DA SAUDE::MEDICINA

Resuscitation thoracotomy (RT), a procedure performed to manage patients in extremis, has remained among the most polarizing and controversial surgical acts performed by physicians since its first formal description in the 1960s. However, it is currently unquestionable to perform RT in patients with vital signs and absence of pulse after penetrating chest injury, although there are still relative indications for performing the procedure in cases of blunt trauma or absence of vital signs. In the present study, the objective was to analyze the performance and outcome of RT performed in patients victims of penetrating and blunt trauma in a trauma referral hospital in southern Brazil over a peri od of seven years. This is a retrospective study based on the analysis of medical records of patients undergoing RT, from 2014 to 2020, in the emergency service of the Hospital do Trabalhador, Curitiba - Paraná, Brazil. We evaluated 46 RT that were performed during the study period, of which 89.1% (41) were male. The mean age of patients undergoing RT was 34.1 ± 12.94 years (range 16 and 69 years). Penetrating trauma corresponded to the majority of RT indications with 80.4% (37), of which 86.5% (40) were firearm wound victims and 13.5% (six) were stab wound victims. Only 19.6% (nine) undergoing RT were victims of blunt trauma. 84.78% (39) of the patients had declared deaths during the procedure, considered nonresponders. 15.22% (seven) of patients survived after the procedure. Of these seven, five patients died, three within 24 hours after the procedure due to hemodynamic complications and refractory shock; and two patients with late deaths, one due to infectious complications and septic shock of pulmonary focus and the other due to neurological complications being declared brain death. 4.35% (two) of patients undergoing RT were discharged from the hospital, one of which was victim of blunt trauma. In conclusion, the results showed that there is benefit in its performance in patients victims of severe penetrating trauma, and in some selected situations in blunt trauma.