Acute traumatic disruption of the thoracic aorta: Emergency department management
To evaluate the safety and effectiveness of temporary IV antihypertensive therapy in patients with acute traumatic thoracic aortic disruption. Retrospective chart review of all patients treated for proven traumatic aortic disruption during the ten-year period of 1980 through 1989. Emergency departme...
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| Veröffentlicht in: | Annals of emergency medicine 1992-04, Vol.21 (4), p.391-396 |
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| container_title | Annals of emergency medicine |
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| creator | Warren, Ralph L Akins, Cary W Conn, Alasdair K.T. Hilgenberg, Alan D McCabe, Charles J |
| description | To evaluate the safety and effectiveness of temporary IV antihypertensive therapy in patients with acute traumatic thoracic aortic disruption.
Retrospective chart review of all patients treated for proven traumatic aortic disruption during the ten-year period of 1980 through 1989.
Emergency department of a large, urban, Level I trauma center.
Preoperative IV β-blockade and nitroprusside after initial resuscitation in hemodynamically stable patients.
Thirty-seven patients with angiographically proven aortic disruption were separated retrospectively into one of three groups. Group 1 (15 patients without preoperative antihypertensive therapy) had two deaths. Group 2 (15 patients treated for two to seven hours [mean, 3.8 hours] before surgery with antihypertensives) had one death. Group 3 (seven patients treated with antihypertensives for 24 hours to four months before surgery to allow recovery from associated severe injuries) had one death. There were no complications resulting from antihypertensive therapy.
Temporary antihypertensive therapy appears to be safe and effective in patients with aortic disruption. |
| doi_str_mv | 10.1016/S0196-0644(05)82657-5 |
| format | Article |
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Retrospective chart review of all patients treated for proven traumatic aortic disruption during the ten-year period of 1980 through 1989.
Emergency department of a large, urban, Level I trauma center.
Preoperative IV β-blockade and nitroprusside after initial resuscitation in hemodynamically stable patients.
Thirty-seven patients with angiographically proven aortic disruption were separated retrospectively into one of three groups. Group 1 (15 patients without preoperative antihypertensive therapy) had two deaths. Group 2 (15 patients treated for two to seven hours [mean, 3.8 hours] before surgery with antihypertensives) had one death. Group 3 (seven patients treated with antihypertensives for 24 hours to four months before surgery to allow recovery from associated severe injuries) had one death. There were no complications resulting from antihypertensive therapy.
Temporary antihypertensive therapy appears to be safe and effective in patients with aortic disruption.</description><identifier>ISSN: 0196-0644</identifier><identifier>EISSN: 1097-6760</identifier><identifier>DOI: 10.1016/S0196-0644(05)82657-5</identifier><identifier>PMID: 1554176</identifier><identifier>CODEN: AEMED3</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Adolescent ; Adult ; Aged ; Antihypertensive agents ; Antihypertensive Agents - administration & dosage ; Aorta, Thoracic - injuries ; Aorta, Thoracic - surgery ; aortic disruption ; Aortic Rupture - drug therapy ; Aortic Rupture - etiology ; Aortic Rupture - mortality ; Biological and medical sciences ; Cardiovascular system ; Emergencies ; Female ; Humans ; Injury Severity Score ; Male ; Medical sciences ; Middle Aged ; Nitroprusside - administration & dosage ; Paraplegia - physiopathology ; Pharmacology. Drug treatments ; Postoperative Complications - physiopathology ; Premedication ; Retrospective Studies ; Safety</subject><ispartof>Annals of emergency medicine, 1992-04, Vol.21 (4), p.391-396</ispartof><rights>1992 Syntex Laboratories, Inc.</rights><rights>1992 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-277df2dcb29c9aaf3f9d5dd350da8b55465b60985a5108abd60eff846090e76e3</citedby><cites>FETCH-LOGICAL-c389t-277df2dcb29c9aaf3f9d5dd350da8b55465b60985a5108abd60eff846090e76e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0196-0644(05)82657-5$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5273197$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1554176$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Warren, Ralph L</creatorcontrib><creatorcontrib>Akins, Cary W</creatorcontrib><creatorcontrib>Conn, Alasdair K.T.</creatorcontrib><creatorcontrib>Hilgenberg, Alan D</creatorcontrib><creatorcontrib>McCabe, Charles J</creatorcontrib><title>Acute traumatic disruption of the thoracic aorta: Emergency department management</title><title>Annals of emergency medicine</title><addtitle>Ann Emerg Med</addtitle><description>To evaluate the safety and effectiveness of temporary IV antihypertensive therapy in patients with acute traumatic thoracic aortic disruption.
Retrospective chart review of all patients treated for proven traumatic aortic disruption during the ten-year period of 1980 through 1989.
Emergency department of a large, urban, Level I trauma center.
Preoperative IV β-blockade and nitroprusside after initial resuscitation in hemodynamically stable patients.
Thirty-seven patients with angiographically proven aortic disruption were separated retrospectively into one of three groups. Group 1 (15 patients without preoperative antihypertensive therapy) had two deaths. Group 2 (15 patients treated for two to seven hours [mean, 3.8 hours] before surgery with antihypertensives) had one death. Group 3 (seven patients treated with antihypertensives for 24 hours to four months before surgery to allow recovery from associated severe injuries) had one death. There were no complications resulting from antihypertensive therapy.
Temporary antihypertensive therapy appears to be safe and effective in patients with aortic disruption.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antihypertensive agents</subject><subject>Antihypertensive Agents - administration & dosage</subject><subject>Aorta, Thoracic - injuries</subject><subject>Aorta, Thoracic - surgery</subject><subject>aortic disruption</subject><subject>Aortic Rupture - drug therapy</subject><subject>Aortic Rupture - etiology</subject><subject>Aortic Rupture - mortality</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular system</subject><subject>Emergencies</subject><subject>Female</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nitroprusside - administration & dosage</subject><subject>Paraplegia - physiopathology</subject><subject>Pharmacology. Drug treatments</subject><subject>Postoperative Complications - physiopathology</subject><subject>Premedication</subject><subject>Retrospective Studies</subject><subject>Safety</subject><issn>0196-0644</issn><issn>1097-6760</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1r3DAQhkVJSTdpf0LAh1Kag9uRbUlWLiWEfEGglLZnMZZGicra3khyIf--2uySHnPSoPeZDx7GTjh84cDl15_AtaxBdt1nEKd9I4WqxRu24qBVLZWEA7Z6Qd6xo5T-AIDuGn7IDrkQHVdyxX6c2yVTlSMuI-ZgKxdSXDY5zFM1-yo_lOxhjmhLhHPMeFZdjhTvabJPlaMNxjzSlKsRJ7ynbfmevfW4TvRh_x6z31eXvy5u6rvv17cX53e1bXud60Yp5xtnh0Zbjehbr51wrhXgsB_KeVIMEnQvUHDocXASyPu-K39ASlJ7zD7t5m7i_LhQymYMydJ6jRPNSzKq6aWWbVdAsQNtnFOK5M0mhhHjk-FgtirNs0qz9WRAmGeVRpS-k_2CZRjJ_e_auSv5x32OyeLaR5xsSC-YaFTLtSrYtx1GRcbfQNEkG4o-ciGSzcbN4ZVD_gHP1pDz</recordid><startdate>19920401</startdate><enddate>19920401</enddate><creator>Warren, Ralph L</creator><creator>Akins, Cary W</creator><creator>Conn, Alasdair K.T.</creator><creator>Hilgenberg, Alan D</creator><creator>McCabe, Charles J</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19920401</creationdate><title>Acute traumatic disruption of the thoracic aorta: Emergency department management</title><author>Warren, Ralph L ; Akins, Cary W ; Conn, Alasdair K.T. ; Hilgenberg, Alan D ; McCabe, Charles J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-277df2dcb29c9aaf3f9d5dd350da8b55465b60985a5108abd60eff846090e76e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Antihypertensive agents</topic><topic>Antihypertensive Agents - administration & dosage</topic><topic>Aorta, Thoracic - injuries</topic><topic>Aorta, Thoracic - surgery</topic><topic>aortic disruption</topic><topic>Aortic Rupture - drug therapy</topic><topic>Aortic Rupture - etiology</topic><topic>Aortic Rupture - mortality</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular system</topic><topic>Emergencies</topic><topic>Female</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nitroprusside - administration & dosage</topic><topic>Paraplegia - physiopathology</topic><topic>Pharmacology. Drug treatments</topic><topic>Postoperative Complications - physiopathology</topic><topic>Premedication</topic><topic>Retrospective Studies</topic><topic>Safety</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Warren, Ralph L</creatorcontrib><creatorcontrib>Akins, Cary W</creatorcontrib><creatorcontrib>Conn, Alasdair K.T.</creatorcontrib><creatorcontrib>Hilgenberg, Alan D</creatorcontrib><creatorcontrib>McCabe, Charles J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Warren, Ralph L</au><au>Akins, Cary W</au><au>Conn, Alasdair K.T.</au><au>Hilgenberg, Alan D</au><au>McCabe, Charles J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute traumatic disruption of the thoracic aorta: Emergency department management</atitle><jtitle>Annals of emergency medicine</jtitle><addtitle>Ann Emerg Med</addtitle><date>1992-04-01</date><risdate>1992</risdate><volume>21</volume><issue>4</issue><spage>391</spage><epage>396</epage><pages>391-396</pages><issn>0196-0644</issn><eissn>1097-6760</eissn><coden>AEMED3</coden><abstract>To evaluate the safety and effectiveness of temporary IV antihypertensive therapy in patients with acute traumatic thoracic aortic disruption.
Retrospective chart review of all patients treated for proven traumatic aortic disruption during the ten-year period of 1980 through 1989.
Emergency department of a large, urban, Level I trauma center.
Preoperative IV β-blockade and nitroprusside after initial resuscitation in hemodynamically stable patients.
Thirty-seven patients with angiographically proven aortic disruption were separated retrospectively into one of three groups. Group 1 (15 patients without preoperative antihypertensive therapy) had two deaths. Group 2 (15 patients treated for two to seven hours [mean, 3.8 hours] before surgery with antihypertensives) had one death. Group 3 (seven patients treated with antihypertensives for 24 hours to four months before surgery to allow recovery from associated severe injuries) had one death. There were no complications resulting from antihypertensive therapy.
Temporary antihypertensive therapy appears to be safe and effective in patients with aortic disruption.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>1554176</pmid><doi>10.1016/S0196-0644(05)82657-5</doi><tpages>6</tpages></addata></record> |
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| ispartof | Annals of emergency medicine, 1992-04, Vol.21 (4), p.391-396 |
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| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Adolescent Adult Aged Antihypertensive agents Antihypertensive Agents - administration & dosage Aorta, Thoracic - injuries Aorta, Thoracic - surgery aortic disruption Aortic Rupture - drug therapy Aortic Rupture - etiology Aortic Rupture - mortality Biological and medical sciences Cardiovascular system Emergencies Female Humans Injury Severity Score Male Medical sciences Middle Aged Nitroprusside - administration & dosage Paraplegia - physiopathology Pharmacology. Drug treatments Postoperative Complications - physiopathology Premedication Retrospective Studies Safety |
| title | Acute traumatic disruption of the thoracic aorta: Emergency department management |
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