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Abstract

Thoracic trauma causes significant morbidity and mortality. Some thoracic injuries are life-threatening and early diagnosis and prompt treatment is mandatory. A thorough evaluation of the patient and a systematic approach is necessary to manage the severity of different injuries. Knowledge of the trauma mechanisms and their specific injuries are required to improve patient care and decrease unfavorable outcomes and complications. This chapter gives an overview of the diagnostic procedures and classification model necessary for an accurate assessment of patients with thoracic trauma. Furthermore, it describes the occurrence of the various thoracic injuries and their treatment options.

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References

  1. LoCicero 3rd J, Mattox KL. Epidemiology of chest trauma. Surg Clin North Am. 1989;69(1):15–9.

    Article  PubMed  Google Scholar 

  2. Lansink KWW, Gunning AC, Leenen LPH. Cause of death and time of death distribution of trauma patients in a level I trauma centre in the Netherlands. Eur J Trauma Emerg Surg. 2013;39:375–83.

    Article  CAS  PubMed  Google Scholar 

  3. American College of Surgeons Committee on trauma. Advanced trauma life support for doctors, student course manual. 8th ed. Chicago: American College of Surgeons Committee on Trauma; 2008.

    Google Scholar 

  4. van Wessem KJ, Hennus MP, van Wagenberg L, Koenderman L, Leenen LP. Mechanical ventilation increases the inflammatory response induced by lung contusion. J Surg Res. 2013;183(1):377–84.

    Article  PubMed  Google Scholar 

  5. Eren S, Balci AE, Ulku R, Cakir O, Eren MN. Thoracic firearm injuries in children: management and analysis of prognostic factors. Eur J Cardiothorac Surg. 2003;23(6):888–93.

    Article  PubMed  Google Scholar 

  6. Oestern HJ, Kabus K. The classification of the severely and multiply injured – what has been established? Chirurg. 1997;68(11):1059–65.

    Article  CAS  PubMed  Google Scholar 

  7. Mommsen P, Zeckey C, Andruszkow H, Weidemann J, Frömke C, Puljic P, van Griensven M, Frink M, Krettek C, Hildebrand F. Comparison of different thoracic trauma scoring systems in regards to prediction of post-traumatic complications and outcome in blunt chest trauma. J Surg Res. 2012;176(1):239–47.

    Article  PubMed  Google Scholar 

  8. Pape HC, Remmers D, Rice J, Ebisch M, Krettek C, Tscherne H. Appraisal of early evaluation of blunt chest trauma: development of a standardized scoring system for initial clinical decision making. J Trauma. 2000;49(3):496–504.

    Article  CAS  PubMed  Google Scholar 

  9. Berg EE, Chebuhar C, Bell RM. Pelvic trauma imaging: a blinded comparison of computed tomography and roentgenograms. J Trauma. 1996;41:994–8.

    Article  CAS  PubMed  Google Scholar 

  10. Costello P, Dupuy D, Ecker C, TEllo R. Spiral CT of the thorax with small volumes of contrast material: a comparative study. Radiology. 1992;183:663–6.

    Article  CAS  PubMed  Google Scholar 

  11. Traub M, Stevenson M, McEvoy S, Briggs G, Lo SK, Leibman S, Joseph T. The use of chest computed tomography versus chest X-ray in patients with major blunt trauma. Injury. 2007;38(1):43–7.

    Article  PubMed  Google Scholar 

  12. Cook AD, Klein JS, Rogers FB, Osler TM, Shackford SR. Chest radiographs of limited utility in the diagnosis of blunt traumatic aortic laceration. J Trauma. 2001;50(5):843–7.

    Article  CAS  PubMed  Google Scholar 

  13. Trupka A, Waydhas C, Hallfeldt KK, Nast-Kolb D, Pfeifer KJ, Schweiberer L. Value of thoracic computed tomography in the first assessment of severely injured patients with blunt chest trauma: results of a prospective study. J Trauma. 1997;43(3):405–11; discussion 411–2.

    Article  CAS  PubMed  Google Scholar 

  14. Kea B, Gamarallage R, Vairamuthu H, Fortman J, Lunney K, Hendey GW, Rodriguez RM. What is the clinical significance of chest CT when the chest x-ray result is normal in patients with blunt trauma? Am J Emerg Med. 2013;31(8):1268–73.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Rodriguez RM, Anglin D, Langdorf MI, Baumann BM, Hendey GW, Bradley RN, Medak AJ, Raja AS, Juhn P, Fortman J, Mulkerin W, Mower WR. NEXUS chest: validation of a decision instrument for selective chest imaging in blunt trauma. JAMA Surg. 2013;148(10):940–6.

    Article  PubMed  Google Scholar 

  16. Hyacinthe AC, Broux C, Francony G, Genty C, Bouzat P, Jacquot C, Albaladejo P, Ferretti GR, Bosson JL, Payen JF. Diagnostic accuracy of ultrasonography in the acute assessment of common thoracic lesions after trauma. Chest. 2012;141(5):1177–83.

    Article  PubMed  Google Scholar 

  17. Wilkerson RG, Stone MB. Sensitivity of bedside ultrasound and supine anteroposterior chest radiographs for the identification of pneumothorax after blunt trauma. Acad Emerg Med. 2010;17(1):11–7.

    Article  PubMed  Google Scholar 

  18. Dente CJ, Ustin J, Feliciano DV, Rozycki GS, Wyrzykowski AD, Nicholas JM, Salomone JP, Ingram WL. The accuracy of thoracic ultrasound for detection of pneumothorax is not sustained over time: a preliminary study. J Trauma. 2007;62(6):1384–9.

    Article  PubMed  Google Scholar 

  19. Restrepo CS, Gutierrez FR, Marmol-Velez JA, Ocazionez D, Martinez-Jimenez S. Imaging patients with cardiac trauma. Radiographics. 2012;32(3):633–49.

    Article  PubMed  Google Scholar 

  20. Karalis DG, Victor MF, Davis GA, McAllister MP, Covalesky VA, Ross Jr JJ, Foley RV, Kerstein MD, Chandrasekaran K. The role of echocardiography in blunt chest trauma: a transthoracic and transesophageal echocardiographic study. J Trauma. 1994;36(1):53–8.

    Article  CAS  PubMed  Google Scholar 

  21. Chirillo F, Totis O, Cavarzerani A, Bruni A, Farnia A, Sarpellon M, Ius P, Valfrè C, Stritoni P. Usefulness of transthoracic and transoesophageal echocardiography in recognition and management of cardiovascular injuries after blunt chest trauma. Heart. 1996;75(3):301–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Martin M, Satterly S, Inaba K, Blair K. Does needle thoracostomy provide adequate and effective decompression of tension pneumothorax? J Trauma Acute Care Surg. 2012;73(6):1412–7.

    Article  PubMed  Google Scholar 

  23. Harcke HT, Mabry RL, Mazuchowski EL. Needle thoracentesis decompression: observations from postmortem computed tomography and autopsy. J Spec Oper Med. 2013;13(4):53–8.

    PubMed  Google Scholar 

  24. Fitzgerald M, Mackenzie CF, Marasco S, Hoyle R, Kossmann T. Pleural decompression and drainage during trauma reception and resuscitation. Injury. 2008;39(1):9–20.

    Article  CAS  PubMed  Google Scholar 

  25. Inaba K, Lustenberger T, Recinos G, Georgiou C, Velmahos GC, Brown C, Salim A, Demetriades D, Rhee P. Does size matter? A prospective analysis of 28–32 versus 36–40 French chest tube size in trauma. J Trauma Acute Care Surg. 2012;72(2):422–7.

    Article  PubMed  Google Scholar 

  26. Bosman A, de Jong MB, Debeij J, van den Broek PJ, Schipper IB. Systematic review and meta-analysis of antibiotic prophylaxis to prevent infections from chest drains in blunt and penetrating thoracic injuries. Br J Surg. 2012;99(4):506–13.

    Article  CAS  PubMed  Google Scholar 

  27. Butler FK, Dubose JJ, Otten EJ, Bennett DR, Gerhardt RT, Kheirabadi BS, Gross KR, Cap AP, Littlejohn LF, Edgar EP, Shackelford SA, Blackbourne LH, Kotwal RS, Holcomb JB, Bailey JA. Management of open pneumothorax in tactical combat casualty care: TCCC guidelines change 13–02. J Spec Oper Med. 2013;13(3):81–6.

    PubMed  Google Scholar 

  28. Mattox KL, Allen MK. Systematic approach to pneumothorax, haemothorax, pneumomediastinum and subcutaneous emphysema. Injury. 1986;17(5):309–12.

    Article  CAS  PubMed  Google Scholar 

  29. Mowery NT, Gunter OL, Collier BR, Diaz Jr JJ, Haut E, Hildreth A, Holevar M, Mayberry J, Streib E. Practice management guidelines for management of hemothorax and occult pneumothorax. J Trauma. 2011;70(2):510–8.

    Article  PubMed  Google Scholar 

  30. Simon B, Ebert J, Bokhari F, Capella J, Emhoff T, Hayward 3rd T, Rodriguez A, Smith L, Eastern Association for the Surgery of Trauma. Management of pulmonary contusion and flail chest: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5 Suppl 4):S351–61.

    Article  PubMed  Google Scholar 

  31. Waydhas C. Thoracic trauma. Unfallchirurg. 2000;103(10):871–89; quiz 890, 910.

    Article  CAS  PubMed  Google Scholar 

  32. Lee TH, Ouellet JF, Cook M, Schreiber MA, Kortbeek JB. Pericardiocentesis in trauma: a systematic review. J Trauma Acute Care Surg. 2013;75(4):543–9.

    Article  PubMed  Google Scholar 

  33. Aukema TS, Beenen LF, Hietbrink F, Leenen LP. Initial assessment of chest X-ray in thoracic trauma patients: awareness of specific injuries. World J Radiol. 2012;4(2):48–52.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Oveland NP, Lossius HM, Wemmelund K, Stokkeland PJ, Knudsen L, Sloth E. Using thoracic ultrasonography to accurately assess pneumothorax progression during positive pressure ventilation: a comparison with CT scanning. Chest. 2013;143(2):415–22.

    Article  PubMed  Google Scholar 

  35. Wilson H, Ellsmere J, Tallon J, Kirkpatrick A. Occult pneumothorax in the blunt trauma patient: tube thoracostomy or observation? Injury. 2009;40(9):928–31.

    Article  PubMed  Google Scholar 

  36. Moore FO, Goslar PW, Coimbra R, Velmahos G, Brown CV, Coopwood Jr TB, Lottenberg L, Phelan HA, Bruns BR, Sherck JP, Norwood SH, Barnes SL, Matthews MR, Hoff WS, de Moya MA, Bansal V, Hu CK, Karmy-Jones RC, Vinces F, Pembaur K, Notrica DM, Haan JM. Blunt traumatic occult pneumothorax: is observation safe? – results of a prospective, AAST multicenter study. J Trauma. 2011;70(5):1019–23; discussion 1023–5.

    Article  PubMed  Google Scholar 

  37. Kirkpatrick AW, Rizoli S, Ouellet JF, Roberts DJ, Sirois M, Ball CG, Xiao ZJ, Tiruta C, Meade M, Trottier V, Zhu G, Chagnon F, Tien H, Canadian Trauma Trials Collaborative and the Research Committee of the Trauma Association of Canada. Occult pneumothoraces in critical care: a prospective multicenter randomized controlled trial of pleural drainage for mechanically ventilated trauma patients with occult pneumothoraces. J Trauma Acute Care Surg. 2013;74(3):747–54; discussion 754–5.

    Article  PubMed  Google Scholar 

  38. Kulvatunyou N, Erickson L, Vijayasekaran A, Gries L, Joseph B, Friese RF, O'Keeffe T, Tang AL, Wynne JL, Rhee P. Randomized clinical trial of pigtail catheter versus chest tube in injured patients with uncomplicated traumatic pneumothorax. Br J Surg. 2014;101(2):17–22.

    Article  CAS  PubMed  Google Scholar 

  39. Trupka A, Nast-Kolb D, Schweiberer L. Thoracic trauma. Unfallchirurg. 1998;101(4):244–58.

    Article  CAS  PubMed  Google Scholar 

  40. Oğuzkaya F, Akçali Y, Bilgin M. Videothoracoscopy versus intrapleural streptokinase for management of post traumatic retained haemothorax: a retrospective study of 65 cases. Injury. 2005;36(4):526–90.

    Article  PubMed  Google Scholar 

  41. Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, Hemmila MR, O'Connor JV, McKenney MO, Moore FO, London J, Singh MJ, Lineen E, Spaniolas K, Keel M, Sugrue M, Wahl WL, Hill J, Wall MJ, Moore EE, Margulies D, Malka V, Chan LS, American Association for the Surgery of Trauma Thoracic Aortic Injury Study Group. Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma Multicenter Study. J Trauma. 2008;64(3):561–70.

    Article  PubMed  Google Scholar 

  42. Hershberger RC, Aulivola B, Murphy M, Luchette FA. Endovascular grafts for treatment of traumatic injury to the aortic arch and great vessels. J Trauma. 2009;67(3):660–71.

    Article  PubMed  Google Scholar 

  43. Smakman N, Nicol AJ, Walther G, Brooks A, Navsaria PH, Zellweger R. Factors affecting outcome in penetrating oesophageal trauma. Br J Surg. 2004;91(11):1513–9.

    Article  CAS  PubMed  Google Scholar 

  44. Sepesi B, Raymond DP, Peters JH. Esophageal perforation: surgical, endoscopic and medical management strategies. Curr Opin Gastroenterol. 2010;26(4):379–83.

    Article  PubMed  Google Scholar 

  45. Simali M, Türüt H, Topçu S, Gülhan E, Yazici Ü, Kaya S, Taştepe I. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003;24:133–8.

    Article  Google Scholar 

  46. Bergeron E, Lavoie A, Clas D, Moore L, Ratte S, Tetreault S, Lemaire J, Martin M. Elderly trauma patients with rib fractures are at greater risk of death and pneumonia. J Trauma. 2003;54(3):478–85.

    Article  PubMed  Google Scholar 

  47. Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly. J Trauma. 2000;48(6):1040–6; discussion 1046–7.

    Article  CAS  PubMed  Google Scholar 

  48. Flagel BT, Luchette FA, Reed RL, et al. Half-a-dozen ribs: the breakpoint for mortality. Surgery. 2005;138:717–25.

    Article  PubMed  Google Scholar 

  49. Holcomb JB, McMullin NR, Kozar RA, Lygas MH, Moore FA. Morbidity from rib fractures increases after age 45. J Am Coll Surg. 2003;196(4):549–55.

    Article  PubMed  Google Scholar 

  50. Todd SR, McNally MM, Holcomb JB, et al. A multidisciplinary clinical pathway decreases rib fracture-associated infectious morbidity and mortality in high-risk trauma patients. Am J Surg. 2006;192:806–11.

    Article  PubMed  Google Scholar 

  51. Kent R, Woods W, Bostrom O. Fatality risk and the presence of rib fractures. Ann Adv Automot Med. 2008;52:73–82.

    PubMed  PubMed Central  Google Scholar 

  52. Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, Shimazaki S. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma. 2002;52(4):727–32.

    PubMed  Google Scholar 

  53. Nirula R, Mayberry JC. Rib fracture fixation: controversies and technical challenges. Am Surg. 2010;76(8):793–802.

    PubMed  Google Scholar 

  54. Leinicke JA, Elmore L, Freeman BD, Colditz GA. Operative management of rib fractures in the setting of flail chest. A systematic review and meta-analysis. Ann Surg. 2013;258(6):914–21.

    Article  PubMed  Google Scholar 

  55. Brookes JG, Dunn RJ, Rogers IR. Sternal fractures: a retrospective analysis of 272 cases. J Trauma. 1993;35:46.

    Article  CAS  PubMed  Google Scholar 

  56. Budd JS. Effect of seat belt legislation on the incidence of sternal fractures seen in the accident department. Br Med J. 1985;291:785.

    Article  CAS  Google Scholar 

  57. Sadaba JR, Oswal D, Munsch CM. Management of isolated sternal fractures: determining the risk of blunt cardiac injury. Ann R Coll Surg Engl. 2000;82(3):162–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  58. Sangster GP, González-Beicos A, Carbo AI, Heldmann MG, Ibrahim H, Carras-cosa P, Nazar M, D'Agostino HB. Blunt traumatic injuries of the lung parenchyma, pleura, thoracic wall, and intrathoracic airways: multidetector computer tomography imaging findings. Emerg Radiol. 2007;14(5):297–310.

    Article  PubMed  Google Scholar 

  59. Wagner RB, Crawford Jr WO, Schimpf PP. Classification of parenchymal injuries of the lung. Radiology. 1988;167(1):77–82.

    Article  CAS  PubMed  Google Scholar 

  60. Cohn SM, Dubose JJ. Pulmonary contusion: an update on recent advances in clinical management. World J Surg. 2010;34(8):1959–70.

    Article  PubMed  Google Scholar 

  61. François B, Desachy A, Cornu E, Ostyn E, Niquet L, Vignon P. Traumatic pulmonary hernia: surgical versus conservative management. J Trauma. 1998;44(1):217–9.

    Article  PubMed  Google Scholar 

  62. Arslanian A, Oliaro A, Donati G, Filosso PL. Posttraumatic pulmonary hernia. J Thorac Cardiovasc Surg. 2001;122(3):619–21.

    Article  CAS  PubMed  Google Scholar 

  63. Prêtre R, Chilcott M. Blunt trauma to the heart and great vessels. N Engl J Med. 1997;336(9):626–32.

    Article  PubMed  Google Scholar 

  64. Clancy K, Velopulos C, Bilaniuk JW, Collier B, Crowley W, Kurek S, Lui F, Nayduch D, Sangosanya A, Tucker B, Haut ER, Eastern Association for the Surgery of Trauma. Screening for blunt cardiac injury: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5 Suppl 4):S301–6.

    Article  PubMed  Google Scholar 

  65. Sybrandy KC, Cramer MJ, Burgersdijk C. Diagnosing cardiac contusion: old wisdom and new insights. Heart. 2003;89(5):485–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Christensen MD, Nielsen PE, Sleight P. Prior blunt chest trauma may be a cause of single vessel coronary disease; hypothesis and review. Int J Cardiol. 2006;108(1):1–5.

    Article  PubMed  Google Scholar 

  67. Nan YY, Lu MS, Liu KS, Huang YK, Tsai FC, Chu JJ, Lin PJ. Blunt traumatic cardiac rupture: therapeutic options and outcomes. Injury. 2009;40(9):938–45.

    Article  PubMed  Google Scholar 

  68. Brathwaite CE, Rodriguez A, Turney SZ, Dunham CM, Cowley R. Blunt traumatic cardiac rupture. A 5-year experience. Ann Surg. 1990;212(6):701–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Rotondo MF, Schwab CW, McGonigal MD, Phillips 3rd GR, Fruchterman TM, Kauder DR, Latenser BA, Angood PA. ‘Damage control’: an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma. 1993;35(3):375–82.

    Article  CAS  PubMed  Google Scholar 

  70. Giannoudis PV, Pape HC. Damage control orthopaedics in unstable pelvic ring injuries. Injury. 2004;35(7):671–7.

    Article  CAS  PubMed  Google Scholar 

  71. Pape HC, van Griensven M, Rice J, Gänsslen A, Hildebrand F, Zech S, Winny M, Lichtinghagen R, Krettek C. Major secondary surgery in blunt trauma patients and perioperative cytokine liberation: determination of the clinical relevance of biochemical markers. J Trauma. 2001;50(6):989–1000.

    Article  CAS  PubMed  Google Scholar 

  72. Goris RJ, Gimbrère JS, van Niekerk JL, Schoots FJ, Booy LH. Improved survival of multiply injured patients by early internal fixation and prophylactic mechanical ventilation. Injury. 1982;14(1):39–43.

    Article  CAS  PubMed  Google Scholar 

  73. Bone LB, Johnson KD, Weigelt J, Scheinberg R. Early versus delayed stabilization of femoral fractures. A prospective randomized study. J Bone Joint Surg Am. 1989;71(3):336–40.

    Article  CAS  PubMed  Google Scholar 

  74. Pape HC, Auf'm'Kolk M, Paffrath T, Regel G, Sturm JA, Tscherne H. Primary intramedullary femur fixation in multiple trauma patients with associated lung contusion – a cause of posttraumatic ARDS? J Trauma. 1993;34(4):540–7.

    Article  CAS  PubMed  Google Scholar 

  75. Hildebrand F, Giannoudis P, Kretteck C, Pape HC. Damage control: extremities. Injury. 2004;35(7):678–89.

    Article  PubMed  Google Scholar 

  76. Gray AC, White TO, Clutton E, Christie J, Hawes BD, Robinson CM. The stress response to bilateral femoral fractures: a comparison of primary intramedullary nailing and external fixation. J Orthop Trauma. 2009;23(2):90–7.

    Article  CAS  PubMed  Google Scholar 

  77. Robinson CM, Ludlam CA, Ray DC, Swann DG, Christie J. The coagulative and cardiorespiratory responses to reamed intramedullary nailing of isolated fractures. J Bone Joint Surg Br. 2001;83(7):963–73.

    Article  CAS  PubMed  Google Scholar 

  78. Pape HC, Rixen D, Morley J, Husebye EE, Mueller M, Dumont C, Gruner A, Oestern HJ, Bayeff-Filoff M, Garving C, Pardini D, van Griensven M, Krettek C, Giannoudis P, EPOFF Study Group. Impact of the method of initial stabilization for femoral shaft fractures in patients with multiple injuries at risk for complications (borderline patients). Ann Surg. 2007;246(3):491–9.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Taeger G, Ruchholtz S, Waydhas C, Lewan U, Schmidt B, Nast-Kolb D. Damage control orthopedics in patients with multiple injuries is effective, time saving, and safe. J Trauma. 2005;59(2):409–16.

    Article  PubMed  Google Scholar 

  80. Nowotarski PJ, Turen CH, Brumback RJ, Scarboro JM. Conversion of external fixation to intramedullary nailing for fractures of the shaft of the femur in multiply injured patients. J Bone Joint Surg Am. 2000;82(6):781–8.

    Article  CAS  PubMed  Google Scholar 

  81. Pape HC, Grimme K, Van Griensven M, Sott AH, Giannoudis P, Morley J, Roise O, Ellingsen E, Hildebrand F, Wiese B, Krettek C, EPOFF Study Group. Impact of intramedullary instrumentation versus damage control for femoral fractures on immunoinflammatory parameters: prospective randomized analysis by the EPOFF Study Group. J Trauma. 2003;55(1):7–13.

    Article  PubMed  Google Scholar 

  82. Hietbrink F, Koenderman L, Rijkers G, Leenen L. Trauma: the role of the innate immune system. World J Emerg Surg. 2006;1:15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Keel M, Trentz O. Pathophysiology of polytrauma. Injury. 2005;36(6):691–709.

    Article  PubMed  Google Scholar 

  84. Pape HC, Bund M, Meier R, Piepenbrock S, von Glinski S, Tscherne H. Pulmonary dysfunction following primary bilateral femoral nailing – a case report. Intensive Care Med. 1999;25(5):547.

    Article  CAS  PubMed  Google Scholar 

  85. Hietbrink F, Koenderman L, Leenen LP. Intramedullary nailing of the femur and the systemic activation of monocytes and neutrophils. World J Emerg Surg. 2011;6:34. doi:10.1186/1749-7922-6-34.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Bernard GR, Artigas A, Brigham KL. The American-European Consensus Conference on ARDS: definition, mechanisms, relevant outcomes and clinical trial coordination. Am J Respir Crit Care Med. 1994;149:818–24.

    Article  CAS  PubMed  Google Scholar 

  87. Miller PR, Croce MA, Kilgo PD, Scott J, Fabian TC. Acute respiratory distress syndrome in blunt trauma: identification of independent risk factors. Am Surg. 2002;68(10):845–50.

    PubMed  Google Scholar 

  88. Becher RD, Colonna AL, Enniss TM, Weaver AA, Crane DK, Martin RS, Mowery NT, Miller PR, Stitzel JD, Hoth JJ. An innovative approach to predict the development of adult respiratory distress syndrome in patients with blunt trauma. J Trauma Acute Care Surg. 2012;73(5):1229–35.

    Article  PubMed  Google Scholar 

  89. Sharma S. Acute respiratory distress syndrome. Clin Evid (Online). 2010;2010. pii:1511.

    Google Scholar 

  90. Pai GP, Bhatti NA, Ellison RG, Rubin JW, Moore HV. Thoracic duct injury from blunt trauma. South Med J. 1984;77(5):667–8.

    Article  CAS  PubMed  Google Scholar 

  91. Romero S. Nontraumatic chylothorax. Curr Opin Pulm Med. 2000;6(4):287–91.

    Article  CAS  PubMed  Google Scholar 

  92. McCormick 3rd J, Henderson SO. Blunt trauma-induced bilateral chylothorax. Am J Emerg Med. 1999;17(3):302–4.

    Article  PubMed  Google Scholar 

  93. Dugue L, Sauvanet A, Farges O, Goharin A, Le Mee J, Belghiti J. Output of chyle as an indicator of treatment for chylothorax complicating oesophagectomy. Br J Surg. 1998;85(8):1147–9.

    Article  CAS  PubMed  Google Scholar 

  94. Seitelman E, Arellano JJ, Takabe K, Barrett L, Faust G, Angus LD. Chylothorax after blunt trauma. J Thorac Dis. 2012;4(3):327–30.

    PubMed  PubMed Central  Google Scholar 

  95. Itkin M, Kucharczuk JC, Kwak A, Trerotola SO, Kaiser LR. Nonoperative thoracic duct embolization for traumatic thoracic duct leak: experience in 109 patients. J Thorac Cardiovasc Surg. 2010;139(3):584–9.

    Article  PubMed  Google Scholar 

  96. DuBose J, Inaba K, Demetriades D, Scalea TM, O'Connor J, Menaker J, Morales C, Konstantinidis A, Shiflett A, Copwood B, AAST Retained Hemothorax Study Group. Management of post-traumatic retained hemothorax: a prospective, observational, multicenter AAST study. J Trauma Acute Care Surg. 2012;72(1):11–22; discussion 22–4; quiz 316.

    Article  PubMed  Google Scholar 

  97. Ahmed N, Jones D. Video-assisted thoracic surgery: state of the art in trauma care. Injury. 2004;35(5):479–89. Review. Billeter AT, Druen D, Franklin GA, Smith JW, Wrightson W, Richardson JD. Video-assisted thoracoscopy as an important tool for trauma surgeons: a systematic review. Langenbecks Arch Surg. 2013;398(4):515–23.

    Article  CAS  PubMed  Google Scholar 

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de Jong, M.B., Kokke, M.C., Hietbrink, F., Leenen, L.P.H. (2016). Chest Trauma. In: Pape, HC., Sanders, R., Borrelli, Jr., J. (eds) The Poly-Traumatized Patient with Fractures. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47212-5_8

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