EMERGENCY EVALUATION AND MANAGEMENT FOR TRAUMATIC PULMONARY ARTERY INJURIES

• DOI: 10.22533/at.ed.1593522310074

• Palavras-chave: Pulmonary artery; Chest injuries; Complications.

• Keywords: Pulmonary artery; Chest injuries; Complications.

• Abstract:

  The aim of this study was to identify the evaluation and emergency management options available for traumatic pulmonary artery injuries, considering the most effective diagnostic and therapeutic approaches to minimize damage and improve prognosis. Methodology: A literature review was carried out through searches in the Scientific Electronic Library Online (Scielo) and PubMed databases. 159 articles were found, of which 7 studies were selected after applying the inclusion criteria. Result: The initial evaluation of traumatic pulmonary artery injuries involves a multidisciplinary approach that includes clinical evaluation, hemodynamic stabilization and use of imaging tests, such as computed tomography (CT) of the chest. Computed tomography angiography (CT angiography) and conventional angiography are useful modalities to assess the extent of the lesion and determine the treatment plan. Emergency management of traumatic pulmonary artery injuries depends on the severity of the injury and the clinical condition of the patient. For hemodynamically stable patients, the initial evaluation after the ATLS protocol involves performing a CT scan to assess the extent of the injury. For hemodynamically unstable patients, however, more invasive interventions are required, such as the insertion of a Resuscitative Endovascular Aortic Balloon Occlusion (REBOA) device and referral to the operating room for damage control and repair of the pulmonary artery. Conclusion: Appropriate management of patients with traumatic pulmonary artery injuries is essential due to the high mortality rate. Management varies according to hemodynamic stability, with stable patients undergoing computed tomography to assess the extent of the lesion, while unstable patients undergo insertion of REBOA and are referred for surgery.