Misunderstood cardiac involvement with heart impairment in traumatic sternal fracture: an enzimatic-guided evaluation

Monaco, Maurizio and Mondello, Baldassarre and Monaco, Francesco and Vasta, I. and Perrone, Ottorino and Micali, Vincenzo and Barone, Mario (2009) Misunderstood cardiac involvement with heart impairment in traumatic sternal fracture: an enzimatic-guided evaluation. Il giornale di chirurgia, 30 (3). pp. 117-120. ISSN 1971-145X

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Abstract

Background. Isolated sternal fractures occur more and more frequently in traffic road accidents in particular after the introduction of the seat-belt law. This study sets out to assess by laboratory parameters the incidence and consequences of pericardial and myocardial involvement in sternal injury. Patients and methods: Between June 1997 and March 2007, 50 consecutive patients were admitted to our Thoracic Surgical Unit with acute traumatic sternal fractures. X-ray, CT scan, standard 12-lead electrocardiogram (ECG) and echocardiographic evaluation were obtained in all patients. (28 males, 22 females), with displaced and undisplaced fractures. The patients were hospitalised for cardiorespiratory monitoring, pain control and physiotherapy. Oxygen implementation was performed to obtain an arterial saturation above 96%. Supplementary investigations or therapeutic interventions were assessed if clinically indicated.Results. Our data, according to literature, show that sternal trauma must be careful evaluated by monitoring of vital parameters. In our collection we have no mortality with complex comorbidity. The interparametric relation between laboratory values and cardiac involvement was not significant anyway . The prolonged CK-MB peak level in a large number of patients is related with cardiac impairment. Conclusions. Our results suggest that in traumatic sternal fratures enzymatic activity of CK-MB, echocardiographic investigation and careful monitorizing for the first 96 hours are necessary. The cardiac compliance is inadequate in politraumatic patients and can lead to cardiac impairment

Item Type:	Article
Uncontrolled Keywords:	Sternal fracture, Myocardial enzymes, Sternal osteosynthesis
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia > 617.4 Chirurgia secondo il Sistema e Regioni
Depositing User:	Nadia Del Gobbo
Date Deposited:	04 Feb 2016 12:17
Last Modified:	04 Feb 2016 12:17
URI:	http://eprints.bice.rm.cnr.it/id/eprint/5688

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