TY - JOUR
T1 - Evaluation and management of blunt traumatic aortic injury
T2 - A practice management guideline from the Eastern Association for the Surgery of Trauma
AU - Fox, Nicole
AU - Schwartz, Diane
AU - Salazar, Jose H.
AU - Haut, Elliott R.
AU - Dahm, Philipp
AU - Black, James H.
AU - Brakenridge, Scott C.
AU - Como, John J.
AU - Hendershot, Kimberly
AU - King, David R.
AU - Maung, Adrian A.
AU - Moorman, Matthew L.
AU - Nagy, Kimberly
AU - Petrey, Laura B.
AU - Tesoriero, Ronald
AU - Scalea, Thomas M.
AU - Fabian, Timothy C.
N1 - Publisher Copyright:
Copyright © 2015 Society of Trauma Nurses.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Background: Blunt traumatic aortic injury (BTAI) is the second most common cause of death in trauma patients. Eighty percent of patients with BTAI will die before reaching a trauma center. The issues of how to diagnose, treat, and manage BTAI were first addressed by the Eastern Association for the Surgery of Trauma (EAST) in the practice management guidelines on this topic published in 2000. Since that time, there have been advances in the management of BTAI. As a result, the EAST guidelines committee decided to develop updated guidelines for this topic using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework recently adopted by EAST. Methods: A systematic review of the MEDLINE database using PubMed was performed. The search retrieved English language articles regarding BTAI from 1998 to 2013. Letters to the editor, case reports, book chapters, and review articles were excluded. Topics of investigation included imaging to diagnose BTAI, type of operative repair, and timing of operative repair. Results: Sixty articles were identified. Of these, 51 articles were selected to construct the guidelines. Conclusion: There have been changes in practice since the publication of the previous guidelines in 2000. Computed tomography of the chest with intravenous contrast is strongly recommended to diagnose clinically significant BTAI. Endovascular repair is strongly recommended for patients without contraindications. Delayed repair of BTAI is suggested, with the stipulation that effective blood pressure control must be used in these patients. (J Trauma Acute Care Surg. 2015;78:125-135. Level of Evidence: Systematic reviews and meta-analyses, level III.
AB - Background: Blunt traumatic aortic injury (BTAI) is the second most common cause of death in trauma patients. Eighty percent of patients with BTAI will die before reaching a trauma center. The issues of how to diagnose, treat, and manage BTAI were first addressed by the Eastern Association for the Surgery of Trauma (EAST) in the practice management guidelines on this topic published in 2000. Since that time, there have been advances in the management of BTAI. As a result, the EAST guidelines committee decided to develop updated guidelines for this topic using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework recently adopted by EAST. Methods: A systematic review of the MEDLINE database using PubMed was performed. The search retrieved English language articles regarding BTAI from 1998 to 2013. Letters to the editor, case reports, book chapters, and review articles were excluded. Topics of investigation included imaging to diagnose BTAI, type of operative repair, and timing of operative repair. Results: Sixty articles were identified. Of these, 51 articles were selected to construct the guidelines. Conclusion: There have been changes in practice since the publication of the previous guidelines in 2000. Computed tomography of the chest with intravenous contrast is strongly recommended to diagnose clinically significant BTAI. Endovascular repair is strongly recommended for patients without contraindications. Delayed repair of BTAI is suggested, with the stipulation that effective blood pressure control must be used in these patients. (J Trauma Acute Care Surg. 2015;78:125-135. Level of Evidence: Systematic reviews and meta-analyses, level III.
KW - Blunt aortic injury
KW - Blunt aortic trauma
KW - Traumatic aortic injury
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U2 - 10.1097/JTN.0000000000000118
DO - 10.1097/JTN.0000000000000118
M3 - Article
C2 - 25768967
AN - SCOPUS:84942760177
SN - 1078-7496
VL - 22
SP - 99
EP - 110
JO - Journal of Trauma Nursing
JF - Journal of Trauma Nursing
IS - 2
ER -