Non-Conventional Management of Penetrating Cardiac Trauma: AnIntegrative Literature Review

Abstract

Introduction. In the last 30 years, the therapeutic pericardial window has become an alternative for the approach of patients with Cardiac Penetrating Trauma (CPT) without hemodynamic compromise. Its usefulness lies in the drainage of the hemopericardium, decreasing the rate of non-therapeutic sternotomy and/or thoracotomy. This review presents a state of the art on this therapeutic approach.

Methods. An integrative review of the literature was carried out with an active search of articles published from 1980 to the present time, in English and Spanish, in different databases that included in their description the non conventional management of SPT by means of pericardic window and hemopericardic drainage, and that within their outcomes evaluated mortality, postoperative complications and/or hospital stay.

Results. Seven studies were included: three experimental and four descriptive. Overall mortality in patients with TCP was 5.4%. Those who underwent pericardial window and hemopericardial drainage had a lower mortality rate (0.6%) compared to those who underwent conventional management with sternotomy and/or thoracotomy (9.18%). Similarly, the rate of complications was lower in the first group (24.2% vs. 20.6% respectively), as well as hospital stay (3.7 vs. 6.7 days), respectively.

Discussion. Evidence shows that management with pericardial window and hemopericardial drainage in patients with SCT and hemodynamic stability is safe. Mortality rates, complications and hospital stay are lower than those of conventional management with sternotomy and/or thoracotomy.