Resuscitative thoracotomy in France: For whom? By whom?

Abstract

Resuscitative thoracotomy is preferentially addressed to patients with penetrating thoracic injury and suffering from severe treatment-resistant hemodynamic instability, without pulse or in cardiopulmonary arrest for at most 15minutes. It is practicable in an emergency room, or ideally, in an operating theater. The procedure always begins with left anterolateral thoracotomy and can be prolonged through transversal bi-thoracotomy or, more rarely and according to the presumed origin of the hemorrhage, through median sternotomy. In most cases the procedures to be carried out are relatively simple, and when they are more complex, it is possible to effectuate temporary hemostasis while awaiting the assistance of a second surgeon. We are persuaded that the above procedure should imperatively be learned and become part and parcel of the therapeutic arsenal of the surgeon tasked with management of trauma patients.