Contemporary management of traumatic cardiac arrest and peri-arrest states: a narrative review.

Cardiac tamponade Clamshell Exsanguinating Hypovolaemia Hypoxia REBOA Tension pneumothorax Thoracotomy Trauma Traumatic cardiac arrest

Journal

Journal of anesthesia, analgesia and critical care
ISSN: 2731-3786
Titre abrégé: J Anesth Analg Crit Care
Pays: England
ID NLM: 9918591885906676

Informations de publication

Date de publication:
26 Sep 2024
Historique:
received: 08 07 2024
accepted: 29 08 2024
medline: 27 9 2024
pubmed: 27 9 2024
entrez: 26 9 2024
Statut: epublish

Résumé

Trauma is a leading cause of death and disability worldwide across all age groups, with traumatic cardiac arrest (TCA) presenting a significant economic and societal burden due to the loss of productive life years. Despite TCA's high mortality rate, recent evidence indicates that survival with good and moderate neurological recovery is possible. Successful resuscitation in TCA depends on the immediate and simultaneous treatment of reversible causes according to pre-established algorithms. The HOTT protocol, addressing hypovolaemia, oxygenation (hypoxia), tension pneumothorax, and cardiac tamponade, forms the foundation of TCA management. Advanced interventions, such as resuscitative thoracotomy and resuscitative endovascular balloon occlusion of the aorta (REBOA), further enhance treatment. Contemporary approaches also consider metabolic factors (e.g. hyperkalaemia, calcium imbalances) and hemostatic resuscitation. This narrative review explores the advanced management of TCA and peri-arrest states, discussing the epidemiology and pathophysiology of peri-arrest and TCA. It integrates classic TCA management strategies with the latest evidence and practical applications.

Identifiants

pubmed: 39327636
doi: 10.1186/s44158-024-00197-9
pii: 10.1186/s44158-024-00197-9
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

66

Informations de copyright

© 2024. The Author(s).

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Auteurs

Luca Carenzo (L)

Department of Anesthesia and Intensive Care Medicine, IRCCS Humanitas Research Hospital, Rozzano, Milano, 20089, Italy. luca.carenzo@hunimed.eu.

Giulio Calgaro (G)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy.

Marius Rehn (M)

Pre-Hospital Division, Air Ambulance Department, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
The Norwegian Air Ambulance Foundation, Oslo, Norway.

Zane Perkins (Z)

Centre for Trauma Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
London's Air Ambulance and Barts Health NHS Trust, Royal London Hospital, London, UK.

Zaffer A Qasim (ZA)

Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

Lorenzo Gamberini (L)

Department of Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy.

Ewoud Ter Avest (E)

London's Air Ambulance and Barts Health NHS Trust, Royal London Hospital, London, UK.
Department of Emergency Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.

Classifications MeSH