Evidence map›Paper›PMID 35005164›Full record

ArticleTrauma case reports2022

Critical anterior mediastinal hematoma without internal mammary artery injury caused by cardiopulmonary resuscitation: A case report.

Hirotaka Nishimura, Yuki Mochida, Satoyuki Ogino, Kei Fukushi, Hiroyuki Yamazaki, Yasuhiko Miyakuni, Yasuhiko Kaita, Toshinori Minamishima, Kyoko Soejima, Yoshihiro Yamaguchi

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In one paragraph

Article in Trauma case reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Hirotaka NishimuraDepartment of Trauma and Critical Care Medicine, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Yuki MochidaDepartment of Trauma and Critical Care Medicine, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Satoyuki OginoDepartment of Trauma and Critical Care Medicine, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Kei FukushiDepartment of Cardiovascular Medicine, Kyorin University Hospital, 6-20-2, Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Hiroyuki YamazakiDepartment of Cardiovascular Medicine, Kyorin University Hospital, 6-20-2, Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Yasuhiko MiyakuniDepartment of Trauma and Critical Care Medicine, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Yasuhiko KaitaDepartment of Trauma and Critical Care Medicine, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Toshinori MinamishimaDepartment of Cardiovascular Medicine, Kyorin University Hospital, 6-20-2, Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Kyoko SoejimaDepartment of Cardiovascular Medicine, Kyorin University Hospital, 6-20-2, Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Yoshihiro YamaguchiDepartment of Trauma and Critical Care Medicine, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo 181-8611, Japan.
Kyorin University · JPKyorin University Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMassive anterior mediastinal hematoma due to chest compression during cardiopulmonary resuscitation is often caused by internal mammary artery injury. However, critical massive anterior mediastinal hematoma without damage to major blood vessels is extremely rare. We report a case of life-threatening anterior mediastinal hematoma without internal mammary artery injury during extracorporeal cardiopulmonary resuscitation. CASE PRESENTATION: A 70-year-old man was transferred to our emergency department because of ventricular fibrillation arrest. Manual chest compressions and venoarterial extracorporeal membrane oxygenation were applied in the angiography room. Acute myocardial infarction was diagnosed, and percutaneous coronary intervention with stent placement was performed. Despite the establishment of venoarterial extracorporeal membrane oxygenation flow, the hemodynamics were unstable. Computed tomography revealed a massive anterior mediastinal hematoma compressing the right heart system and causing obstructive shock. Although local incision and anterior mediastinal hematoma drainage were tried for resolving obstructive shock, the patient's anemia did not improve, and there was still continuous hemorrhaging from the drainage tube. A median thoracotomy was then performed. There was no injury of the main trunk of the internal mammary artery but only hemorrhaging from the sternal fracture site. The patient's hemodynamics and anemia improved after hemostasis and gauze packing. Re-thoracotomy for gauze removal and sternal closure was performed three days post-hospitalization.

conclusionsIt is important to consider hemorrhaging and unstable hemodynamics in patients who receive extracorporeal cardiopulmonary resuscitation. Therefore, a thoracotomy may take precedence over intravascular treatment for restoring hemostasis when there is no information regarding the bleeding site, such as the presence of extravasation.

Indexed as

HemostasisMedian thoracotomyObstructive shockSternal fractureVenoarterial extracorporeal membrane oxygenation

Identifiers

PMID35005164
PMCPMC8718651
OpenAlexW4200223148

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.