Use of cardiopulmonary bypass to salvage patients with heart wounds: A consecutive series of 36patients from a Scandinavian hospital

Abstract: Thoracic injuries account for 25% of all trauma deaths annually. Immediate deaths involve disruption of the heart or great vessel injury. Early deaths (those occurring within 30mins to 3 hours) are due to cardiac tamponade, tension pneumothorax, aspiration, or airway obstruction. Pulmonary sepsis and missed injuries account of the late deaths. Objectives: To review our experience with penetrating heartinjuries at the SU/Sahlgrenska University hospitalwith cardiopulmonary bypass (CPB) in trauma, complemented by a comparison with European and global experience with penetrating heart injuries and CPB treatment to outline indications for its expanded use in trauma management. Methods: Medical records were reviewed for demographicand physiological data, operative findings, and outcome.A retrospective study of 36 consecutive patients with penetrating, and blunt trauma to the chest was conducted over 6 years at our trauma unit. Patient details, mechanism of injury, operativeprocedure and in-hospital mortality and morbidity rates were recorded. All available published English-language articles from peer reviewed journals, found by MEDLINE database. Conclusions: Cardiopulmonary bypass is essential in some patientswith complex multiple-chamber cardiac injuries that could notbe exposed andrepaired by other means.Further studies by other trauma centers will be needed for standardized indications for the use of CPB in trauma.