Ulus Travma Acil Cerrahi Derg. 2010; 16(3): 220-224

Penetrating cardiac trauma in children

Mustafa Goz¹, Ömer Cakir², Mehmet Nesimi Eren^3
1Harran University School Of Medicine,department Of Cardiovascular Surgery, Sanliurfa, Turkey
²Fatih University School Of Medicine, Department Of Cardiovascular Surgery, Ankara, Turkey
³Dicle University School Of Medicine, Department Of Cardiovascular Surgery, Diyarbakir, Turkey

BACKGROUND
Penetrating cardiac traumas in children are dramatic and fatal. Many of the patients are admitted to hospital either in a state of shock or they are dead at presentation. In this study, we aimed to present our experience in penetrating cardiac trauma in children.
METHODS
Seventeen pediatric cases of penetrating cardiac trauma were retrospectively evaluated. The effects on the results of the demographic characteristics of patients, etiology of penetrating trauma, time of presentation to the hospital, physical examination findings in the emergency department, diagnostic methods used, and the surgical techniques applied were evaluated.
RESULTS
The male to female ratio of the 17 retrospectively evaluated cases was 16: 1, with an age range of 3-15 years. The patients’ mean age was 12.94±3.52 years. In all patients, the penetrating cardiac trauma was due to incisive/penetrating tools. The mean Ivatury physiologic index score was 8.23±0.78, whereas the mean cardiac injury organ scale score was 5.00±0.00. The hospital mortality rate was 5.9% due to the loss of one patient.
CONCLUSION
Shock may develop in pediatric penetrating cardiac trauma in a short time due to hemorrhage and/or cardiac tamponade. The prime factors for patient survival are early diagnosis and emergency thoracotomy.

Keywords: Cardiac injuries, emergency room thoracotomy; pediatric thoracic trauma; Ivatury physiologic index score; ketamine.

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Çocuklarda penetran kalp yaralanmalarý

Mustafa Goz¹, Ömer Cakir², Mehmet Nesimi Eren^3
1Harran Üniversitesi Týp Fakültesi, Kalp Damar Cerrahisi Anabilim Dalý, Þanlýurfa, Türkiye
²Fatih Üniversitesi Týp Fakültesi, Kalp Damar Cerrahisi Anabilim Dalý, Ankara, Türkiye
³Dicle Üniversitesi Týp Fakültesi, Kalp Damar Cerrahisi Anabilim Dalý, Diyarbakýr, Türkiye

AMAÇ
Çocuklarda penetran kalp yaralanmalarý dramatik ve ölümcül travmalardýr. Birçok olgu, hastaneye ciddi þokta veya hayatýný kaybetmiþ olarak ulaþýr. Bu çalýþmamýzda penetran kalp yaralanmasý olan çocuk hastalarýmýzla ilgili deneyimimizi aktarmayý amaçladýk.
GEREÇ VE YÖNTEM
Penetran kalp yaralanmalý 17 çocuk hasta geriye dönük olarak incelendi. Hastalarýn demografik karakterleri, yaralanmanýn nedenleri, hastaneye geliþ zamaný, acil servis inceleme bulgularý, kullanýlan taný yöntemleri ve uygulanan cerrahi yöntemlerin sonuçlar üzerine etkisi incelendi.
BULGULAR
Geriye dönük analizleri yapýlan 17 hastanýn erkek-kadýn oraný 16: 1, yaþ aralýðý 3-15 yaþ, ortalama 12,94±3,52 yaþ idi. Tüm hastalarda yaralanma nedeni kesici delici alet yaralanmasý olarak tespit edildi. Ivatury fizyolojik indeks skoru 8.23±0.78 iken ortalama kardiyak yaralanma organ ölçeði skoru 5,00±0,00 olarak bulundu. Bir olgu ile hastane mortalitesi %5,9 olarak tespit edildi.
SONUÇ
Çocuklarda penetran kardiyak yaralanmalarda kanama ve/veya tamponad nedeniyle çok kýsa sürede þok geliþebilir. Erken taný ve acil torakotomi yaralanma sonrasý hastalarýn hayatta kalmasýnda temel faktörlerdir.

Anahtar Kelimeler: Kalp yaralanmasý, acil servis torakotomisi; çocuk toraks travmasý; Ivatury fizyolojik indeks skoru; ketamin.

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