MSS04: UTILITY OF EMERGENT RESUSCITATIVE THORACOTOMY IN COMBAT PATIENTS INJURED IN RUSSO-UKRAINIAN WAR
Igor Lurin, MajorGeneral, Professor1; Eduard Khoroshun, Colonel, PhD2; Vitalii Makarov, PhD, Professor3; Volodymyr Nehoduiko, Colonel, Professor2; Serhii Panasenko, Captain, Professor2; Serhii Shypilov, Colonel, Professor2; Yurii Bunin, Colonel2; Andrii Dinets, PhD, Associate Professor1; 1National Academy of Medical Sciences of Ukraine; 2Department of Thoraco-Abdominal Surgery, Military Medical Teaching Center of the Northern Region of Ministry of Defense of Ukraine; 3Department of Surgery #4, Kharkiv National Medical University, Ukraine
Objectives: Emergent resuscitative thoracotomy (ERT) is surgical procedure to be applied for the patients in extreme condition with acute traumatic cardiac arrest (TCA). ERT is indicated for moribund patient when profound shock is unquestionable and against surgical management. These conditions are seen in combat patients with severe thoracoabdominal gunshot injury in ongoing war in Ukraine.
The aim of this study war to evaluate utility of ERT in the combat patients injured in war in Ukraine.
Methods: There were identified 406 patients with gunshot injuries and TCA who were treated at Role 2 and 3 hospitals. Of these, TCA was managed by closed-chest cardiopulmonary resuscitation (CPR) in 347 patients (85.5%) and by ERT in 59 patients (14.5%). ERT was performed according to ATLS guideline.
Results: Survivors were 96 (23,6%) patients in in CRP group as compared to 27 (6.7%) patents in ERT group. Effectiveness of ERT was better in case of patients admission to hospital within 10 minutes as judged by 23 (85.3%) survivors, as compared 3 (11.6%) patients admitted within 30 min, and 1 (3.1%) patient admitted in 60 min. The majority of patients died due to shock progression. The follow up of 3 days showed survival of 10 (37%) patients treated with ERT vs. 8 (8.6%) patients treated with CRP.
Conclusions: Application of ERT in selected patients is associated with relatively good outcomes. The fast evacuation is associated with better survival in war in Ukraine.