Advanced diagnostic and therapeutic techniques for anaesthetists in thoracic trauma: an evidence-based review

Gabriel A Pollock; Jessie Lo; Henry Chou; Michael S Kissen; Michelle Kim; Vida Zhang; Alexander Betz; Ryan Perlman

doi:10.1016/j.bja.2022.07.005

Advanced diagnostic and therapeutic techniques for anaesthetists in thoracic trauma: an evidence-based review

Br J Anaesth. 2023 Jan;130(1):e80-e91. doi: 10.1016/j.bja.2022.07.005. Epub 2022 Aug 26.

Authors

Gabriel A Pollock¹, Jessie Lo², Henry Chou³, Michael S Kissen⁴, Michelle Kim⁵, Vida Zhang⁶, Alexander Betz⁵, Ryan Perlman⁷

Affiliations

¹ Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Thoracic Anaesthesia, Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Regional Anaesthesia & Acute Pain Service Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: gabriel.pollock@cshs.org.
² Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Regional Anaesthesia & Acute Pain Service Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
³ Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Thoracic Anaesthesia, Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
⁴ Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Thoracic Anaesthesia, Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Regional Anaesthesia & Acute Pain Service Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
⁵ Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
⁶ Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Thoracic Anaesthesia, Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Trauma Anaesthesia, Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
⁷ Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Trauma Anaesthesia, Department of Anaesthesia, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

PMID: 36096943
DOI: 10.1016/j.bja.2022.07.005

Abstract

Anaesthetists play an important role in the evaluation and treatment of patients with signs of thoracic trauma. Anaesthesia involvement can provide valuable input using both advanced diagnostic and therapeutic interventions. Commonly performed interventions may be complicated in this setting including airway management, damage control resuscitation, and acute pain management. Anaesthetists must consider additional factors including airway injuries, vascular injuries, and coagulopathy when treating this population. This evidence-based review discusses traumatic thoracic injuries with a focus on new interventions and modern anaesthesia techniques. This review further serves to support the early involvement of anaesthetists in the emergency department and other areas where they can provide value to the trauma care pathway.

Keywords: POCUS; lung isolation; point-of care ultrasound; regional anaesthesia; thoracic trauma; trauma anaesthesia; viscoelastic testing.

Publication types

Review

MeSH terms

Airway Management / methods
Anesthesia*
Anesthesiology*
Anesthetists
Humans
Thoracic Injuries* / diagnosis
Thoracic Injuries* / therapy