Objective: To analyze the literature on the current status of emergency room thoracotomy. Data collection: Review of the literature, from the first experiences of using this technique to the most recent studies. Results: Since its introduction in the 1960s, the use of emergency room thoracotomy has become widespread and it is now part of the resuscitation protocols in all North American trauma centers. Forty-two series were analyzed and 7,035 procedures were found, with 551 survivors (7.8%). According to the mechanism of injury, 4,482 thoracotomies were performed for penetrating injuries, with 500 survivors (11.1%), and 2,193 thoracotomies were performed for blunt trauma, with 35 survivors (1.6%). In the 14 series that reported neurological outcome, there were 4,520 patients who underwent emergency room thoracotomy with 226 survivors (5%), of whom 34 (15%) experienced neurological sequelae and complications. Of the 1,165 patients who underwent emergency room thoracotomy for cardiac injuries, 363 (31.1%) survived. Four series describe emergency room thoracotomy in the pediatric population; 142 patients underwent this procedure, of which 57 were due to penetrating injuries, with a survival rate of 12.2%. Conclusion: Emergency room thoracotomy is a valuable tool for the trauma surgeon that should be employed judiciously, and with strict indications since its indiscriminate use is associated with elevated morbidity and mortality rates. Despite these risks, emergency room thoracotomy remains the last hope for many patients that arrive " in extremis" This procedure must be performed by surgeons with appropriate training in the use of this technique.
All Science Journal Classification (ASJC) codes