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Tue Apr 22 04:30:44 BST 2008

Was it the trauma partner or was it the anesthesiologist who did the great job ?
No kidding, let us know if you do get pulmonary hypertension please. Most of the papers I've seen said it is more likely large TVs (tidal volume, not television) that causes the lung injury and pulmonary edema. I am also not so sure if decreasing the cardiac output and so the amount of blood flowing through the remaining lung..if it is the left lung it may be worse..perhaps..

Ivan Hronek MD

-----Original Message-----
From: Duchesne, Juan C  <jduchesn at tulane.edu>
Sent: Monday, April 21, 2008 7:34 PM
To: Trauma &amp; Critical Care mailing list <trauma-list at trauma.org>; Trauma &amp; Critical Care mailing list <trauma-list at trauma.org>
Subject: Traumatic Pneumonectomy

Trauma Case:
 Just recently one of our trauma partners did a pneumonectomy on a 18 year old male for GSW to hylum with intra-op use of 54 u PRBC, 52 FFP and 26 plts, 10 Cryoprecipitate with 1.2 L of crystalloids! 
This is part of our Damage Control Resuscitation (DCR) at Charity Trauma Center. 
What to expect?
1. place swanz and monitor pulmonary pressures......get flolan, NO in the room.....get ready for a bumpy road!
2. early trach, peg
3. Get DNR
4. DCR is voodoo!
5. extubate and transfer to floor in 5 days
juan
Juan C Duchesne MD, FACS, FCCP
Trauma and Critical Care Surgery Section
Surgical Hospital Center Director
Director Surgical Intensive Care Unit  
Louisiana ATLS / PHTLS State Faculty

Tulane University School of Medicine
1430 Tulane Ave., SL-22
New Orleans LA 70112-2699
Tel. 504-988-5111
Fax. 504-988-3683
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Traumatic Pneumonectomy