INDICATIONS AND OUTCOMES OF PREHOSPITAL RESUSCITATIVE THORACOTOMY

DOI
  • MASHIKO Kazuki
    Shock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital Nippon Medical School Department of Emergency and Critical Care Medicine
  • MATSUMOTO Hisashi
    Shock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital Nippon Medical School Department of Emergency and Critical Care Medicine
  • YASUMATSU Hiroshi
    Shock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital Nippon Medical School Department of Emergency and Critical Care Medicine
  • UEDA Taichiro
    Shock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital Nippon Medical School Department of Emergency and Critical Care Medicine
  • YAMAMOTO Mariko
    Shock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital Nippon Medical School Department of Emergency and Critical Care Medicine
  • OKADA Kazuhiro
    Shock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital Nippon Medical School Department of Emergency and Critical Care Medicine
  • MOTOMURA Tomokazu
    Shock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital Nippon Medical School Department of Emergency and Critical Care Medicine
  • SAITO Nobuyuki
    Shock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital Nippon Medical School Department of Emergency and Critical Care Medicine
  • YAGI Takanori
    Shock & Trauma Center, Nippon Medical School Chiba Hokusoh Hospital Nippon Medical School Department of Emergency and Critical Care Medicine

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Other Title
  • 病院前蘇生的開胸術の適応と効果

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<p>　　A retrospective study was conducted to examine the effects and indications of prehospital resuscitative thoracotomy (pRT).</p><p>　　[Materials and methods] Of 121 patients who underwent pRT at our facility between 2012 and 2018, 119 had searchable medical records and met the inclusion criteria for analysis. Outcomes examined included the 24-hour survival rate, survival discharge rate, and rate of Cerebral Performance Category (CPC) 1-2 at discharge.</p><p>　　[Results] Of the 119 patients, 116 had blunt trauma and 3 had penetrating trauma. At the time of pRT decision, there were 67 cases of asystole, 31 PEA transfers from the ambulance team, and 21 cases of neck pulse absence after physician contact (NPA). There were 12 cases of 24-hour survival and 7 cases of hospital discharge. At hospital discharge, there were 5 patients with CPC1-2 judged to have a good neurological prognosis, including 3 with blunt trauma. In the comparison among the NPA group, PEA group, and Asys group, there were significant differences in the 24-hour survival rate, survival discharge rate, and discharge rate with CPC1-2. Multiple comparisons of survival and discharge rates demonstrated a significant difference between NPA-PEA and NPA-Asys.</p><p>　　[Conclusion] NPA may be a good indication for pRT. Even in Japan where blunt trauma is the main mechanism of injury, pRT may be an option for resuscitative treatment.</p>

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