Objective To evaluate the relationship of the organ injury scale （OIS） with clinical characteristics and survival in penetrating cardiac trauma patients. Methods A retrospective review identified 224 patients with penetrating cardiac trauma. A grade assigned on the basis of the American Association for the Surgery of Trauma OIS was assigned to each case studied. Clinical data, including Glasgow coma scale（GCS）, revised trauma score（RTS）, injury severity score （ISS）, penetrating thoracic trauma index （PTTI）, penetrating trauma index （PTI）, and outcomes were analyzed for association with OIS grade. Results The majority of patients were either grade Ⅳ/ or Ⅴ , with grade Ⅵ having the highest mortality. Patients of grade Ⅰ to Ⅲ were mostly Sub-clinical type patients, and grade Ⅳ to Ⅵ were mostly pericardial tamponade type and hemorrhagic shock type patients. The OIS grade was significantly negative correlated with postinjury duration and GCS （r=-0. 18, -0.16）, and positive correlated with transfusion, ISS, PTTI, PT1, and death（r=0. 17,0. 22,0. 40,0. 41,0. 29）. Conclusion The OIS appears to correlate with severity of injury and survival, and it may be useful in predicting outcomes in patients with penetrating cardiac injury.
Post operational recovery from cardiac surgery can be affected by many factors, including preoperative, intraoperative, and postoperative factors. Prolonged mechanical ventilation (PMV) , one of the major complications, has been widely accepted as a measure to evaluate the performance and outcomes of cardiac surgeries. Great progress has been made in the studies of risk factors contributing to PMV following cardiac surgeries in recent years. However, no clear and effective measures and approaches are available yet to prevent PMV. In this review, the authors try to summarize the risk factors that are associated with PMV throughout the perioperative period of cardiac surgery, as well as possible interventions when applicable.
Objective To summarize clinical outcomes of subxiphoid uniportal video-assisted thoracoscopic surgery for bilateral chest diseases simultaneously. Methods The clinical data of 60 patients with bilateral chest diseases treated by uniportal thoracoscopic surgery via subxiphoid approach in the Department of Thoracic Surgery, Affiliated Hospital of Zunyi Medical College from August 2016 to December 2017 were retrospectively analyzed. There were 35 males and 25 females, aged 25.5±8.8 years ranging from 13 to 51 years. There were 40 patients wtih palmar hyperhidrosis, and 20 patients with bilateral pulmonary bullae and onset of one-side pneumothorax. All patients adopted subxiphoid uniportal video-assisted thoracoscopic surgery. Among them 36 patients with palmar hyperhidrosis underwent resection of R3 bilateral sympathetic nerves, 1 resection of R4 bilateral sympathetic nerves, 3 resection of R3+R4 bilateral sympathetic nerves, and 20 patients with pulmonary bullae underwent bilateral bullectomy and pleurodesis. Results Fifty-five patients cured within 1 to 4 days and discharged after surgery. One patient with incision infection and pulmonary infection after bullectomy, cured and discharged after 3 weeks anti-inflammation and incision dressing change. Four patients with Grade B healing recovered after 1 to 2 weeks dressing change. During the follow-up, no pneumothorax or hand perspiration relapsed. Conclusion Subxiphoid uniportal video-assisted thoracoscopic surgery for simple bilateral chest disease simultaneously is safe and feasible, which not only avoids simultaneous trauma of bilateral punch, but also alleviates the pain of patients.