The tenets of intrathoracic packing during damage control thoracic surgery for trauma patients: a systematic review

Ramiro Manzano-Nunez; Julian Chica; Alexandra Gómez; Maria P. Naranjo; Harold Chaves; Luis E. Muñoz; Javier E. Rengifo; Isabella Caicedo-Holguin; Juan C. Puyana; Alberto F. García

doi:10.1007/s00068-020-01428-8

The tenets of intrathoracic packing during damage control thoracic surgery for trauma patients: a systematic review

Título traducido de la contribución: Los principios del taponamiento intratorácico durante la cirugía torácica de control de daños en pacientes traumatizados: una revisión sistemática

Ramiro Manzano-Nunez
, Julian Chica
, Alexandra Gómez
, Maria P. Naranjo
, Harold Chaves
, Luis E. Muñoz
, Javier E. Rengifo
, Isabella Caicedo-Holguin
, Juan C. Puyana
, Alberto F. García

Producción científica: Contribución a revista › Artículo de revisión › revisión exhaustiva

13 Citas (Scopus)

Resumen

Propósito: Aunque la cirugía torácica de control de daños (DCTS) se ha convertido en una alternativa provocativa para tratar a los pacientes con lesiones torácicas que están críticamente enfermos y fisiológicamente agotados, los enfoques de gestión del empaquetamiento torácico y la medición de los resultados clínicamente relevantes no están bien establecidos. En este artículo, revisamos sistemáticamente los conocimientos y las pruebas disponibles sobre el taponamiento intratorácico durante el DCTS para pacientes traumatizados. Además, informamos sobre los enfoques de manejo, las estrategias quirúrgicas y la mortalidad asociada a esta intervención.

Métodos: Se identificaron artículos en MEDLINE y SCOPUS. Se revisaron todos los estudios que incluían pacientes traumatizados con lesiones torácicas y tratados con taponamiento intratorácico durante el DCTS. Los estudios eran elegibles si se informaba del uso de taponamiento intratorácico en poblaciones traumatizadas.

Resultados: Se identificaron 14 estudios con un total de 211 pacientes. En general, el taponamiento intratorácico se utilizó en 131 pacientes traumatizados. El taponamiento se utilizó con mayor frecuencia para detener la hemorragia coagulopática persistente o la exudación de superficies en carne viva o estructuras reparadas y junto con otras técnicas quirúrgicas. La neumonectomía fue una intervención mortal; sin embargo, un estudio informó de supervivientes cuando se aplazó la neumonectomía.

Conclusiones: El empaquetamiento es un método complementario factible, fiable y potencialmente eficaz para el control de la hemorragia. Por lo tanto, recomendamos que el empaquetamiento se utilice libremente como complemento de las técnicas rápidas de preservación pulmonar.

Título traducido de la contribución	Los principios del taponamiento intratorácico durante la cirugía torácica de control de daños en pacientes traumatizados: una revisión sistemática
Idioma original	Inglés estadounidense
Páginas (desde-hasta)	423–434
Número de páginas	12
Publicación	European Journal of Trauma and Emergency Surgery
Volumen	47
DOI	https://doi.org/10.1007/s00068-020-01428-8
Estado	Publicada - jun. 28 2020
Publicado de forma externa	Sí

ODS de las Naciones Unidas

Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible

ODS 3: Salud y bienestar

Áreas temáticas de ASJC Scopus

Cirugía
Medicina de urgencias
Ortopedia y medicina del deporte
Cuidados y vigilancia intensivos

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10.1007/s00068-020-01428-8

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Manzano-Nunez, R., Chica, J., Gómez, A., Naranjo, M. P., Chaves, H., Muñoz, L. E., Rengifo, J. E., Caicedo-Holguin, I., Puyana, J. C., & García, A. F. (2020). The tenets of intrathoracic packing during damage control thoracic surgery for trauma patients: a systematic review. European Journal of Trauma and Emergency Surgery, 47, 423–434. https://doi.org/10.1007/s00068-020-01428-8

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title = "The tenets of intrathoracic packing during damage control thoracic surgery for trauma patients: a systematic review",

abstract = "Purpose: Although Damage Control Thoracic Surgery (DCTS) has become a provocative alternative to treat patients with chest injuries who are critically ill and physiologically depleted, the management approaches of chest-packing and the measurement of clinically relevant outcomes are not well established. In this paper, we systematically reviewed the available knowledge and evidence about intra-thoracic packing during DCTS for trauma patients. We furthermore inform on the management approaches, surgical strategies, and mortality associated with this intervention. Methods: We identified articles in MEDLINE and SCOPUS. We reviewed all studies that included trauma patients with chest injuries and managed with intrathoracic packing during DCTS. Studies were eligible if the use of intrathoracic packing in trauma populations was reported. Results: We identified 14 studies with a total of 211 patients. Overall, intrathoracic packing was used in 131 trauma patients. Packing was most commonly used to arrest persistent coagulopathic bleeding or oozing either from raw surfaces or repaired structures and in conjunction with other operative techniques. Pneumonectomy was a deadly intervention; however, one study reported survivors when pneumonectomy was deferred. Conclusion: Packing is a feasible, reliable and potentially effective complementary method for hemorrhage control. Therefore, we recommend that packing can be used liberally as a complement to rapid lung-sparing techniques.",

author = "Ramiro Manzano-Nunez and Julian Chica and Alexandra G{\'o}mez and Naranjo, \{Maria P.\} and Harold Chaves and Mu{\~n}oz, \{Luis E.\} and Rengifo, \{Javier E.\} and Isabella Caicedo-Holguin and Puyana, \{Juan C.\} and Garc{\'i}a, \{Alberto F.\}",

year = "2020",

month = jun,

day = "28",

doi = "10.1007/s00068-020-01428-8",

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Manzano-Nunez, R, Chica, J, Gómez, A, Naranjo, MP, Chaves, H, Muñoz, LE, Rengifo, JE, Caicedo-Holguin, I, Puyana, JC & García, AF 2020, 'The tenets of intrathoracic packing during damage control thoracic surgery for trauma patients: a systematic review', European Journal of Trauma and Emergency Surgery, vol. 47, pp. 423–434. https://doi.org/10.1007/s00068-020-01428-8

The tenets of intrathoracic packing during damage control thoracic surgery for trauma patients: a systematic review. / Manzano-Nunez, Ramiro; Chica, Julian; Gómez, Alexandra et al.
En: European Journal of Trauma and Emergency Surgery, Vol. 47, 28.06.2020, p. 423–434.

Producción científica: Contribución a revista › Artículo de revisión › revisión exhaustiva

TY - JOUR

T1 - The tenets of intrathoracic packing during damage control thoracic surgery for trauma patients

T2 - a systematic review

AU - Manzano-Nunez, Ramiro

AU - Chica, Julian

AU - Gómez, Alexandra

AU - Naranjo, Maria P.

AU - Chaves, Harold

AU - Muñoz, Luis E.

AU - Rengifo, Javier E.

AU - Caicedo-Holguin, Isabella

AU - Puyana, Juan C.

AU - García, Alberto F.

PY - 2020/6/28

Y1 - 2020/6/28

N2 - Purpose: Although Damage Control Thoracic Surgery (DCTS) has become a provocative alternative to treat patients with chest injuries who are critically ill and physiologically depleted, the management approaches of chest-packing and the measurement of clinically relevant outcomes are not well established. In this paper, we systematically reviewed the available knowledge and evidence about intra-thoracic packing during DCTS for trauma patients. We furthermore inform on the management approaches, surgical strategies, and mortality associated with this intervention. Methods: We identified articles in MEDLINE and SCOPUS. We reviewed all studies that included trauma patients with chest injuries and managed with intrathoracic packing during DCTS. Studies were eligible if the use of intrathoracic packing in trauma populations was reported. Results: We identified 14 studies with a total of 211 patients. Overall, intrathoracic packing was used in 131 trauma patients. Packing was most commonly used to arrest persistent coagulopathic bleeding or oozing either from raw surfaces or repaired structures and in conjunction with other operative techniques. Pneumonectomy was a deadly intervention; however, one study reported survivors when pneumonectomy was deferred. Conclusion: Packing is a feasible, reliable and potentially effective complementary method for hemorrhage control. Therefore, we recommend that packing can be used liberally as a complement to rapid lung-sparing techniques.

AB - Purpose: Although Damage Control Thoracic Surgery (DCTS) has become a provocative alternative to treat patients with chest injuries who are critically ill and physiologically depleted, the management approaches of chest-packing and the measurement of clinically relevant outcomes are not well established. In this paper, we systematically reviewed the available knowledge and evidence about intra-thoracic packing during DCTS for trauma patients. We furthermore inform on the management approaches, surgical strategies, and mortality associated with this intervention. Methods: We identified articles in MEDLINE and SCOPUS. We reviewed all studies that included trauma patients with chest injuries and managed with intrathoracic packing during DCTS. Studies were eligible if the use of intrathoracic packing in trauma populations was reported. Results: We identified 14 studies with a total of 211 patients. Overall, intrathoracic packing was used in 131 trauma patients. Packing was most commonly used to arrest persistent coagulopathic bleeding or oozing either from raw surfaces or repaired structures and in conjunction with other operative techniques. Pneumonectomy was a deadly intervention; however, one study reported survivors when pneumonectomy was deferred. Conclusion: Packing is a feasible, reliable and potentially effective complementary method for hemorrhage control. Therefore, we recommend that packing can be used liberally as a complement to rapid lung-sparing techniques.

UR - https://www.scopus.com/pages/publications/85086834153

UR - https://www.scopus.com/pages/publications/85086834153#tab=citedBy

U2 - 10.1007/s00068-020-01428-8

DO - 10.1007/s00068-020-01428-8

M3 - Review article

C2 - 32594214

AN - SCOPUS:85086834153

SN - 1863-9933

VL - 47

SP - 423

EP - 434

JO - European Journal of Trauma and Emergency Surgery

JF - European Journal of Trauma and Emergency Surgery

ER -

The tenets of intrathoracic packing during damage control thoracic surgery for trauma patients: a systematic review

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