THORACICTRAUMAANDCRITICALCARETHORACICTRAUMAANDCRITICALCAREeditedbyRiyadKarmy-Jones,MDAveryNathens,MDEricJ.
Stern,MDHarborviewMedicalCenterUniversityofWashingtonSeattle,WashingtonSpringer-Science+BusinessMedia,B.
V.
LibraryofCongressCataloging-in-PublicationDataThoracictraumaandcriticalcare/editedbyRiyadKarmy-Jones,AveryNathens,Eric1.
Stem.
p.
;cm.
Includesbibliographicalreferencesandindex.
ISBN978-1-4613-5407-9ISBN978-1-4615-1127-4(eBook)DOI10.
1007/978-1-4615-1127-41.
Chest--Woundsandinjuries.
2.
Chest--Surgery.
3.
Respiratorydistresssyndrome.
4.
Criticalcaremedicine.
I.
Karmy-Jones,Riyad.
II.
Nathens,AveryIII.
Stem,Eric1.
[DNLM:1.
ThoracicInjuries--therapy.
2.
CriticalCare--methods.
3.
InfectionControl.
4.
RespiratoryDistressSyndrome,Adult--therapy.
5.
ThoracicSurgicalProcedures.
6.
Ventilators,Mechanical.
WF985T48732002]RD536.
T48252002617.
5'4--dc21Copyright2002bySpringerScience+BusinessMediaDordrechtOriginallypublishedbyKluwerAcademicPublishersin2002SoftcoverreprintoftheHardcover1stedition20022002029044Allrightsreserved.
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Tomywife,Lorie,whoeverydaydemonstratesconcentration,courageandcompassion-RKJTomywife,Jane,whoseenduringpatiencehasmadethisbookpossible-ANTomycolleaguesatHarborviewwhostrivedaily(andnightly)tocareforthoselessfortunatethanourselvesandtomybeautifulwife,Karenwhosupportsmeinallmyendeavors.
-EJSCONTRIBUTORSBlaineAchenMDResident,DepartmentofAnesthesiaUniversityofAlbertaEdmonton,AlbertaRichardK.
Albert,M.
D.
ProfessorPulmonaryandCriticalCareMedicineDenverHealthMedicalCenterDenver,COScottK.
AlpardMDDivisionofCardiothoracicSurgeryUniversityofTexasMedicalBranchGalveston,TexasGregoryJ.
Bauer,MDAssistantProfessorofSurgeryCornell-WeillMedicalSchoolNewYork,NYWalterL.
Bim,MD,FACSAssistantProfessorofSurgeryChief,PediatricTraumaDenverHealthMedicalCenterUniversityofColoradoHealthSciencesCenterTylerBlackMDDepartmentofSurgeryUniversityofAlbertaEdmonton,ABRobertD.
BlochMDAssistantProfessorSectionofInterventionalRadiologyDepartmentofRadiologyUniversityofWashingtonSeattle,WAMichaelE.
Boczar,DODepartmentofEmergencyMedicineUniversityofMichiganSchoolofMedicineHurleyMedicalCenterFlint,MichiganJohnJ.
Borsa,MD,FRCPCAssistantProfessor-InterventionalRadiologyUniversityofWashingtonMedicalCenterSeattle,WAEdwardBoyle,Jr.
,MDAttendingCardiothoracicSurgeonSt.
CharlesMedicalCenterHeartInstituteoftheCascadesBend,ORSusanI.
Brundage,MD,MPH,FACSAssistantProfessorofSurgeryTheMichaelE.
DeBakeyDepartmentofSurgeryBaylorCollegeofMedicineHouston,TexasEileenM.
Bulger,MDAssistantProfessorDepartmentofSurgeryHarborviewMedicalCenterSeattle,WAYvonneM.
CarterMDChiefResidentDepartmentofSurgeryHarborviewMedicalCenterSeattle,WACaroleCornejoMDAssistantProfessorDepartmentofSurgeryHarborviewMedicalCenterSeattle,WAJosephCuschieri,MDAssistantProfessorDepartmentofSurgeryUniversityofCincinnatiCincinnati,OHStevenDeemMDAssociateProfessor,AnesthesiologyandMedicine(adjunct,PulmonaryandCriticalCare)UniversityofWashington,HarborviewMedicalCenter,Seattle,WADanielJ.
DiBardinoMDSurgicalResidentTheMichaelE.
DeBakeyDepartmentofSurgeryBaylorCollegeofMedicineHouston,TexasRobertDuBoseMDSurgicalResidentUniversityofWashingtonSeattle,WAThomasR.
Eubanks,DOAssistantProfessorDepartmentofSurgeryUniversityofWashingtonSeattle,WASamirM.
FakhryMD,FACS.
AssociateChairforResearchandEducationChief,TraumaServicesInovaFairfaxHospitalFallsChurch,VAClinicalProfessorofSurgeryGeorgetownUniversityWashington,DCMitchellS.
FarberMD,FACSAttendingSurgeonHurleyMedicalCenterFlint,MIAssistantProfessorDepartmentofSurgeryMichiganStateUniversityviiiAdamGoldinMDChiefResidentDepartmentofSurgeryUniversityofWashingtonMedicalCenterSeattle,WALarryM.
GentilelloMD,FACSAssociateProfessorHarvardMedicalSchoolChief,DivisionofTraumaandCriticalCareBethIsraelDeaconessMedicalCenterBoston,MANicoleGibranMD,FACSAssociateProfessorUniversityofWashingtonBurnCenterHarborviewMedicalCenterSeattle,WADavidGourlayMDResearchFellow,DivisionofTraumaUniversityofWashington,Seattle,WAMystanA.
GurkinMDDepartmentofSurgeryHenryFordHospitalDetroit,MIR.
AlanHallMDAttendingSurgeonDivisionCardiothoracicSurgeryVirginiaMasonMedicalCenterSeattle,WARobertHarrington,MDAssociateProfessorInfectiousDiseasesUniversityofWashingtonHarborviewMedicalCenterSeattle,WADavidM.
Heimbach,MD,FACSProfessor,DepartmentofSurgeryUniversityofWashingtonSeattle,WAH.
MathildaHorst,MD,FACS,FCCMChief,SICUHemyFordHospitalDetroit,MIJamesH.
HolmesIV,MDChiefResidentVirginiaMasonMedicalCenterSeattle,WAEricHofferMDAssociateProfessor,DepartmentofRadiology,UniversityofWashingtonCo-Director,UWAMCEndovascularServicesProgramAssociateDirectorofRadiology,HarborviewMedicalCenterF.
FrankIsikMD,FACSAssociateProfessor,DivisionofPlasticSurgeryDepartmentofSurgeryUniversityofWashingtonSchoolofMedicineJayA.
Johannigman,M.
D.
FACSAssociateProfessorChief,DivisionofTraumaDepartmentofSurgeryUniversityofCincinnatiCincinnati,OHDivyaKapoorMDDepartmentofInternalMedicineUniversityofUtahSaltLakeCity,UTixRiyadKarmy-JonesMD,FACS,FRCS(C),FCCP,FAHAChief,ThoracicSurgeryHarborviewMedicalCenterAssociateProfessorSurgeryDivisionofCardiothoracicSurgeryUniversityofWashingtonSeattle,WALillianSKaoMDAssistantProfessorDepartmentofSurgeryUniversityofTexasHouston,TXRobertR.
Kempainen,MDAssistantProfessorDivisionofAllergy,PulmonaryandCriticalCareMedicineUniversityofMinnesotaMinneapolis,MNNadeemA.
Khan,M.
D.
,M.
P.
H.
ClinicalResearchFellowTraumaServicesInovaFairfaxHospitalFallsChurch,VAAndrewWKirkpatrickMDFRCS(C),FACSSectionofTraumaServicesVancouverGeneralHospital,Vancouver,CanadaJohnB.
KortbeekMD,FRCSC,FACSDirectorTraumaServicesCalgaryHealthRegionClinicalAssociateProfessorDepartmentofSurgeryUniversityofCalgaryCalgary,ABKurtKralovichMD,FACSDivisionofTrauma/SICUHemyFordHospitalDetroit,MIDavidH.
LewisMDAssociateProfessorDirectorNuclearMedicineHarborviewMedicalCenterSeattle,WADonaldE.
Low,MD,FACS,FRCS(C)SectionofGeneral,ThoracicSurgeryVirginiaMasonMedicalCenterSeattle,WashingtonRonaldV.
MaierMD,FACSProfessorandVice-ChairmanDepartmentofSurgeryUniversityofWashingtonSurgeon-in-ChiefHarborviewMedicalCenterSeattle,WACairenJ.
McNameeMD,FRCS(C)Consultant,ThoracicSurgeryUniversityofAlbertaEdmonton,AlbertaMarkH.
Meissner,MD,FACSAssociateProfessorDepartmentofSurgeryHarborviewMedicalCenterUniversityofWashingtonSchoolofMedicineErnestE.
Moore,MD,FACSChief,DepartmentofSurgeryDenverHealthMedicalCenterProfessorandVice-ChairmanofSurgeryUniversityofColoradoHealthSciencesCenterJeffreyMonsonMDChiefResidentDepartmentofSurgeryUniversityofWashingtonSeattle,WAxMichaelS.
MulliganMDChief,LungTransplantProgramDivisionofCardiothoracicSurgeryUniversityofWashingtonSeattle,WAAveryNathensMD,PhD,FRCSC,FACSAssistantProfessorChief,SICUHarborviewMedicalCenterSeattle.
WAMargaretJ.
NeffMD,MScAssistantProfessorofMedicineDirector,CriticalCareResearchDivisionofPulmonary&CriticalCareHarborviewMedicalCenterSeattle,WALindseyA.
NelsonMDDepartmentofSurgeryUniversityofCincinnatiCincinnati,OHSavvasNicolaouMD,FRCP(C)DepartmentofRadiology,VancouverGeneralHospital,Vancouver,CanadaStephenNichols,MD,FACSAssistantProfessorChief,VascularSurgeryHarborviewMedicalCenterSeattle,WARamNirulaMD,MPH,FACSFellow,Trauma/SICUDepartmentofSurgeryHarborviewMedicalCenterUniversityofWashingtonSchoolofMedicineDinhNguyenMDTrauma/SICUFellowHurleyMedicalCenterFlint,MIDavidP.
O'Brien,M.
DDepartmentofSurgeryUniversityofCincinnatiCincinnati,OHFarouckN.
ObeidMD,FACSChief,DepartmentofTrauma/SICUHurleyMedicalCenterFlint,MIProfessorDepartmentofSurgeryMichiganStateUniversityDonaldOxornMD,CM,FRCPC,FACCAssociateProfessorofAnesthesiologyAdjunctAssociateProfessorofMedicineUniversityofWashingtonSchoolofMedicineSeattle,WashingtonManeshParikshak,MDTrauma/CriticalCareFellowHenryFordHospitalDetroit,MichiganDavidJ.
PiersonMDProffessor,PulmonaryandCriticalCareMedicineMedicalDirector,RespiratoryCareHarborviewMedicalCenterSeattle,WATimothyH.
PohlmanMD,FACSProfessorDepartmentofSurgeryHarborviewMedicalCenterUniversityofWashingtonSchoolofMedicineEmanuelP.
Rivers,MD,MPH,FCCMDepartmentsofEmergencyMedicineandSurgeryCaseWesternReserveUniversityHenryFordHospitalDetroit,MichiganxiMatthewRosengartMDChiefResidentUniversityofWashingtonSeattle,WAScottSattlerMDChiefResidentDepartmentofSurgeryUniversityofWashingtonSeattle,WARomualdoJ.
Segrola,Jr.
,MDFellow,CardiothoracicSurgeryUniversityofMinnesotaMinneapolis,MNDavidV.
ShatzMD,FACSAssociateProfessorDepartmentofSurgeryUniversityofMiamiSchoolofMedicineMiami,FLScottE.
Sinclair,M.
D.
ActingClinicalInstructorPulmonaryandCriticalCareMedicineUniversityofWashingtonSeattle,WAShawnJ.
SkerrettMDAssociateProfessorPulmonaryandCriticalCareMedicineUniversityofWashingtonHarborviewMedicalCenterSeattle,WAVictorJ.
SorensenMD,FACSAttendingSurgeonTrauma/SICUHurleyMedicalCenterFlint,MIAssistantProfessorDepartmentofSurgeryMichiganStateUniversityEricSternMDProfessorChiefThoracicRadiologyHarborviewMedicalCenterUniversityofWashingtonSeattle,WAGregoryD.
Trachiotis,MD,FACSAssociateProfessorofSurgeryVice-Chief,DivisionofCardiothoracicSurgeryTheGeorgeWashingtonUniversityMedicalCenterKristinWagner,MDChiefResident,DepartmentofSurgeryTheGeorgeWashingtonUniversityMedicalCenterWashington,DCCherylA.
WhiteMD,PhDSeniorResidentDivisionofPlasticSurgeryDepartmentofSurgeryUniversityofWashingtonSchoolofMedicineDouglasE.
Wood,MD,FACSAssociateProfessorChief,SectionofThoracicSurgeryTheUWEndowedChairinLungCancerResearchDivisionofCardiothoracicSurgeryUniversityofWashingtonSeattle,WAStewartWorrellMDDepartmentofSurgeryUniversityofWashingtonSchoolofMedicineJohnDUrschel,MD,FRCSC,FACS,FRCSEdAssociateProfessorDepartmentofSurgeryMcMasterUniversity,Hamilton,OntarioXllEricVallieres,MD,FRCS(C)AssociateProfessorDivisionofCardiothoracicSurgeryUniversityofWashingtonSeattle,WACurtisF.
Veal,Jr.
,M.
D.
,FACP,FCCPMedicalDirector,KindredHospital-SeattleCo-director,CriticalCareServices,SwedishHealthSystemsClinicalAssociateProfessorofMedicine,UniversityofWashingtonJosephB.
ZwischenbergerMD,FACSProfessorofSurgery,MedicineandRadiologyDirectorGeneralThoracicSurgeryandECMOprogramUniversityofTexasMedicalBranchGalveston,TexasCONTENTS1.
UnderlyingPrinciples1.
1TraumaScores:RecentAdvances:SamirM.
Fakhry,NadeemA.
Khan1.
2CareoftheMultipleInjuredPatientwithThoracicTrauma:FarouckN.
Obeid,MitchellS.
Farber,DinhNguyen1.
3Assessingadequacyofresuscitation:RamNirula,LarryGentillelo1.
4ReperfusionInjury:TimothyH.
Pohlman2.
Thoracostomy,ThoracoscopyandThoracotomy2.
1TubeThoracostomy:JosephCuschieri2.
2Incisionsandapproaches:MitchellS.
Farber,FarouckN.
Obeid2.
3ER-Thoracotomy:AdamGoldin,RiyadKarmy-Jones,CaroleCornejo2.
4UrgentNon-ERThoracotomy:MathewRosengart.
RiyadKarmy-Jones2.
5AbbreviatedThoracotomy;TheEvolvingRoleofDamageControlinThoracicTrauma:DanielJ.
DiBardino.
SusanI.
Brundage.
2.
6TransmediastinalGunshotWounds:DavidV.
Shatz,RomualdoJ.
SergurolaJr.
2.
7RoleofThoracoscopyinChestTrauma:JeffreyMonson,RiyadKarmy-Jones2.
8ManagementofRetainedHemothorax:DavidGourlay2.
9ThoracotomyforMedicalArrest:MichaelE.
Boczar,EmanuelP.
Rivers3.
PulmonaryandAirwayEmergencies3.
1LungInjuries:KurtKralovich3.
2Trachea-bronchialInjuriesDouglasWood3.
3TraumaticAsphyxia:JosephCushieri3.
4PulmonaryBlastInjury:RobertDuBose.
RiyadKarmy-Jones3.
5InhalationInjury:Gregory1.
Bauer.
NicoleGibran,DavidM.
Heimbach3.
6ThoracicMissileEmbolismandRetainedBullets:JohnKortbeek.
DivyaKapoor,RiyadKarmy-Jones3.
7RadiologicalEvaluationofParenchymalInjuries:EricStern3.
8AirwayObstruction:DouglasE.
Wood3.
9ComplicationsofLungTransplantation:MichaelS.
Mulligan3.
lOAirEmbolism:DonaldOxorn3.
11MassiveHemoptysis:CairenJ.
McNamee,TylerBlack,EricVallieres,RiyadKarmy-Jones3.
12Trachea-InominantArteryFistula:BlaineAchen.
M.
D.
,CairenJ.
McNamee,M.
D.
,TylerBlack,M.
D.
3.
13HemoptysisFollowingCatheterInducedRupturesofthePulmonaryArtery:CairenJ.
McNamee,BlaineAchen.
TylerBlack,3.
14Re-expansionPulmonaryEdema:KristinWagner.
GregoryD.
Trachiotis3.
15PostpneumonectomyPulmonaryEdema:JohnUrschel3.
16TheSonographicDetectionofPneumothoraces:Andrew.
W.
KirkpatrickMD,S.
NicolaouMD4.
0ChestWallTrauma4.
1PulmonaryContusionandFlailChest:MedicalManagement:ScottSattler,RonMaier4.
2ReconstructionofComplexChestWallDefects:CherylA.
White,F.
FrankIsik.
MD4.
3ChestWallBurns:NicholeGibran4.
4ChestWallHernia:LillianS.
Kao4.
5DiaphragmaticInjuries:VictorJ.
Sorenson5.
0EsophagealEmergencies5.
1CausticInjuries:ThomasEubanks5.
2Esophagealtraumaandperforation:LillianKaoandRiyadKarmy-Jones6.
0CardiovascularEmergencies6.
1BluntCardiacInjury:WalterL.
Biffl,ErnestE.
Moore6.
2BluntCerebrovascularTrauma:LindseyA.
Nelson,DavidP.
O'Brien,JayA.
Johannigman,6.
3PenetratingCardiacInjury:RiyadKarmy-Jones,StewartWorrell6.
4ManagementofGreatVesselInjury:StephenC.
Nicholls6.
5BluntAorticInjury:DiagnosisJohnBorsa6.
6OperativeManagementOfBluntThoracicAorticInjuries:MathewRosengart,RiyadKarmy-Jones6.
7Non-operativeManagementofBluntThoracicAorticInjuryJamesH.
HolmesIV,R.
AlanHall"andRiyadC.
Karmy-Jones6.
8BluntAorticandGreatVesselInjuries:TheRoleofEndovascularStentRickHoffer6.
9PharmacologicalSupportofShock:StevenDeem6.
10Intra-aorticBalloonPump:EdwardBoyleJr.
6.
11CardiopulmonaryBypass:RiyadKarmy-Jones6.
12DeepVenousThrombosis:ProphylaxisandTreatmentintheCriticallyIIIandInjuredPatient:MarkH.
Meissner6.
13ManagementofAcutePE:YvonneM.
CarterMD,DavidLewisMD,RobertBloch,RiyadKarmy-Jones6.
14Post-OperativeComplicationsofCardiovascularSurgery:RiyadC.
Karmy-Jones7.
0InfectionsintheCriticalCareSetting7.
1DiagnosisofventilatorassociatedpneumoniaShawnSkerret7.
2Empyema:JefferyMonson,RiyadKarmy-Jones7.
3Necrotizingpneumonia:RobertHarrington7.
4SurgicalManagementofComplexParenchymalInfections:JeffreyMonson,RiyadKarmy-Jones7.
5DescendingNecrotizingMediastinitisEricVallieres8.
0RespiratoryIntensiveCare8.
1Ventilation:AnOverview:EileenM.
Bulger8.
2AdultRespiratoryDistressSyndrome:EileenMBulger8.
3HighFrequencyVentilation:ManeshParikshak,MystanA.
Gurkin,H.
MathildaHorst.
8.
4PressureControl-InverseRatioVentilation:MystanA.
Gurkin,ManeshParikshak,H.
MathildaHorst.
xiv8.
5ProneVentilationintheAcuteRespiratoryDistressSyndrome:ScottE.
Sinclair,RichardK.
Albert.
8.
6ECMOinthesurgicalpatient:ScottK.
AlpardandJosephB.
Zwischenberger8.
7LiquidVentilation:MathewRosengart8.
8TheroleofNitricOxideinSepsisandRespiratoryFailure:MargaretNeff8.
9EvaluationandManagementofPersistentAirLeaksinTraumaPatients:RobertKempainanMDandDavidPiersonMD8.
10SurgicalLungBiopsy:Indications,Techniques,OutcomesandControversies:DonaldE.
Low,M.
D.
8.
11FatEmbolism:EileenBulger8.
12TimingofLongBoneFractureFixationinPatientswithBluntThoracicTrauma:RamNirula,AveryB.
Nathens8.
13AcquiredNeuromuscularDisordersintheIntensiveCareUnit:StevenDeem8.
14Weaningthechronicallyventilatedpatient:CurtisVeal8.
15Tracheostomy:DouglasWoodxv
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