Immediate post-traumatic pulmonary embolism is not associated with right ventricular dysfunction.

Autor: Gelbard RB; Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA. Electronic address: rgelbard@hotmail.com., Karamanos E; Division of Surgery, Henry Ford Hospital/Wayne State University, Detroit, MI, USA., Farhoomand A; Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA., Keeling WB; Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA., McDaniel MC; Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA., Wyrzykowski AD; Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA., Shafii SM; Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA., Rajani RR; Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2016 Oct; Vol. 212 (4), pp. 769-774. Date of Electronic Publication: 2015 Oct 22.
DOI: 10.1016/j.amjsurg.2015.08.027
Abstrakt: Background: Post-traumatic pulmonary embolic events are associated with significant morbidity. Computed tomographic (CT) measurements can be predictive of right ventricular (RV) dysfunction after pulmonary embolus. However, it remains unclear whether these physiologic effects or clinical outcomes differ between early (<48 hours) vs late (≥48 hours) post-traumatic pulmonary embolism (PE).
Methods: All patients with traumatic injury and CT evidence of PE between 2008 and 2013 were identified. The study population was divided into 2 groups based on the time of diagnosis of the PE. The primary outcome was PE-related mortality.
Results: Fifty patients were identified (14 early PE and 36 late PE). Patients sustaining a late PE had a higher PE-related mortality rate (16.7% vs 0%), larger RV diameters, RV/left ventricular diameter ratios, RV volumes, and RV/left ventricular volume ratios (all P < .05).
Conclusions: Early post-traumatic PE appears to be associated with fewer RV physiologic changes than late post-traumatic PE and may be representative of primary pulmonary thrombosis. It remains to be seen whether early CT findings of PE should be managed according to previously established guidelines for embolic disease.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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