Login
Site Search
Trauma-List Subscription

Subscribe

Would you like to receive list emails batched into one daily digest?
No Yes
Modify Your Subscription

Modify

Home > List Archives

Aortic "Dissection"

K Mattox kmattox at aol.com
Sat Dec 29 17:07:45 GMT 2012


Aortic dissection does happen, but virtually never following blunt trauma.    One can have a traumatic pseudo-aneurysm or an aortic transaction.    If the patient truly had a post traumatic dissection, the pathophysiology and treatment is different.    

Precision in descriptions in surgery is essential.   

k

Sent from my iPhone

On Dec 29, 2012, at 10:36 AM, "McSwain, Norman E" <nmcswai at tulane.edu> wrote:

> What ere the kinematics? Head on? rotational? lateral?. Damage to the vehicles involved? What is high speed?
> 
> What does HFOV mean?
> 
> Sorry I do not know what " Head with IPH. MRI with profound DAI" means either
> 
> Norman
> 
> Norman McSwain MD, FACS
> Professor of Surgery, Tulane University
> Trauma Director, Spirit of Charity Trauma Center, ILH
> Medical Director PreHosptial Trauma Life Support (PHTLS)
> 504 988 5111
> 
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Keith Lamb
> Sent: Saturday, December 29, 2012 9:49 AM
> To: International Critical Care Medicine Group; Trauma & Critical Care mailing list
> Subject: interesting trauma case
> 
> Will be brief but I need input if possible.
> 
> 38 Year old female. unrestrained driver in high speed MVC. Fatalities at the scene.
> 
> GCS 5T Upon arrival which quickly deteriorates to 3T.
> 
> Major Injuries:
> 
> CT Chest abdomen and pelvis and Head
> 
> Large opacities t/o chest fields. Bilateral pneumothoracies. Pulmonary contusions. Bilateral chest tubes placed. AORTIC DISSECTION
> 
> Abdomen with liver, pancreas, and kidney injuries. Laparotomy done. No occult repairs.
> 
> Pelvis with fracture but no gross blood.
> 
> Head with IPH. MRI with profound DAI.
> 
> Much difficulty in oxygenation and ventilation.
> 
> Today on Volume Assist Control (f) 32, VT 450 (6ml/kg/pbw), FIO2 100%, PEEP 14 7.19, paCO2 55, PaO2 78, HCO3 20
> 
> PCVIRV, APRV, etc has been attempted with worsening gas exchange.
> 
> Two questions right away.
> 
> 1) I am concerned proning her with aortic arch disection. Should I be?
> Worried about heart torquing aorta.
> 
> 2) HFOV. Any contraindications. Seems to me that lower pressure swings on HFOV should be better not worse in terms of her aorta. Yes/No?
> 
> I will send images as soon as possible.
> 
> Thanks for your input.
> 
> Keith
> 
> --
> Keith D. Lamb
> RT II, Surgical Critical Care
> Christiana Care Health System
> Newark, Delaware USA
> 302.983.6178
> 
> Chair, Adult Acute Care Section
> American Association for Respiratory Care
> 
> Director, Board of Directors
> American Association for Respiratory Care
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
> 
> 
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/


More information about the trauma-list mailing list