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  • Title: Survival after trauma pneumonectomy: the pathophysiologic balance of shock resuscitation with right heart failure.
    Author: Baumgartner F, Omari B, Lee J, Bleiweis M, Snyder R, Robertson J, Sheppard B, Milliken J.
    Journal: Am Surg; 1996 Nov; 62(11):967-72. PubMed ID: 8895724.
    Abstract:
    Emergency pneumonectomy for trauma has a high mortality. Although exsanguination is a major factor leading to death, mortality remains high even after adequate resuscitation and is thought to be related to pulmonary edema and right heart failure. We present a series of nine patients who underwent pneumonectomy at Harbor-UCLA from penetrating (7) and blunt (2) trauma. Two patients survived; three initially survived the surgery but died postoperatively of hypoxemia and right heart failure; four died intraoperatively (2 from right heart failure and 2 from exsanguination). One survivor required open cardiac massage for asystole. Careful attention to prevent volume overloading before and during trauma pneumonectomy and maintaining a negative fluid balance postoperatively may contribute to survival in these patients.
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