Emergency pneumonectomy for penetrating and blunt trauma

R. Bowling, C. Mavroudis, J. D. Richardson, L. M. Flint, W. R. Howe, L. A. Gray

Research output: Contribution to journalArticlepeer-review

Abstract

Emergency pneumonectomy for penetrating and blunt trauma has an attendant high mortality. Patients with major lung injuries presenting with prolonged shock followed by control of bleeding, resuscitation with or without aortic cross-clamping and pneumonectomy have had uniformly unsatisfactory results. From 1972 to 1982, eight patients at the University of Louisville Hospital underwent emergency pneumonectomy. All patients underwent expeditions evaluation, resuscitation, and thoracotomy with pneumonectomy. The patients died of exsanguination (2 patients had major associatiated intra-abdominal injuries). Three other patients died due to pulmonary edema and right ventricular failure 2 to 3 hours after hemorrhage has been controlled and intravascular volume restored. Aortic cross-clamping was employed in four patients due to persistent hypovolemia with 100 per cent mortality. Of the two surviving patients, one presented with stable blood pressure and had pneumonectomy for tracheobronchial disruption, while the other had pneumonectomy for tangential laceration of the lung at the hilum. Pulmonary edema and right ventricular failure were responsible for mortality following emergency pneumonectomy and control of hemorrhage and restoration of blood volume. The addition of aortic cross-clamping did not seem to alter survival and may, indeed, hinder therapy due to increased vascular afterload and increased heart failure and pulmonary edema.

Original languageEnglish (US)
Pages (from-to)136-139
Number of pages4
JournalAmerican Surgeon
Volume51
Issue number3
StatePublished - May 23 1985
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

Fingerprint

Dive into the research topics of 'Emergency pneumonectomy for penetrating and blunt trauma'. Together they form a unique fingerprint.

Cite this