Penetrating cardiac wounds: Prospective study of factors influencing initial resuscitation

Robert F. Buckman, Michael M. Badellino, Leann H. Mauro, Juan A. Asensio, Craig Caputo, Jennifer Gass, Julieta D. Grosh

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Abstract

A prospective study of 66 consecutive patients with cardiac wounds seen over a 27- month period is reported. No patient was excluded. Patients were stratified by injury mechanism and by physiologic scoring at admission using the cardiovascular- respiratory elements of the Trauma Score (CVRS). Admission cardiac rhythm was obtained in patients with a CVRS of 0 and a Glasgow Coma Scale (GCS) score of 3. Information concerning the anatomic extent of the cardiac wound, the presence or absence of tamponade, and the degree of injury to other structures was also collected prospectively. Seventy percent of the cardiac wounds were caused by gunshots. The probability of successful resuscitation was significantly related to mechanism of injury and physiologic condition on arrival. Among patients arriving with a CVRS of 0 and a GCS score of 3, survival correlated with cardiac rhythm. Pericardial tamponade did not prove to be an independent predictor of early survival. The presence of tamponade was statistically linked to the mechanism of injury. Transport by non-official conveyance was associated with a higher CVRS on arrival. Intoxication with alcohol or cocaine had no evident effect on resuscitation probability.

Original languageEnglish
Pages (from-to)717-727
Number of pages11
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume34
Issue number5
Publication statusPublished - 1993
Externally publishedYes

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All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine
  • Surgery

Cite this

Buckman, R. F., Badellino, M. M., Mauro, L. H., Asensio, J. A., Caputo, C., Gass, J., & Grosh, J. D. (1993). Penetrating cardiac wounds: Prospective study of factors influencing initial resuscitation. Journal of Trauma - Injury, Infection and Critical Care, 34(5), 717-727.