Anesthetic Management of Thoracic Trauma

Abstract

Thoracic trauma is a morbid business. The American College of Surgeons estimates it is associated with a 10% mortality [1] with 16, 000 deaths annually. That represents 25% of all trauma deaths. Considering that injury is the leading cause of death from ages 1 to 45 (more than half of all deaths ages 13-32 and 80% in teenage years) [2] and the leading cause of years of life lost before 75, its impact is enormous [3]. In one analysis, if injury is taken into account, the life expectancy in the United States rockets from 19th in the developed world to first [4]. Since the vital structures in the chest are so well protected by the bony thorax, a great deal of force is required to disrupt them, and they are uncommonly injured in isolation in blunt trauma. Indeed, 70% of the time, insults to the chest are associated with multisystem injury.