Median Sternotomy in Penetrating Cardiac Trauma

Study Overview
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Brief Summary
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The investigators aim to assess role of median sternotomy in penetrating cardiac trauma regarding morbidity and mortality of the patients.

Detailed Description
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Cardiac trauma is a leading cause of death in the USA and occurs mostly due to motor vehicle accidents. Cardiac trauma may be blunt or as a penetrating chest injuries, and both can lead to aortic injuries. The Right Ventricle followed by the Left Ventricle was the most common site of injury. Timely diagnosis and early management are the key to improve mortality. Mortality related to cardiac trauma remains high despite improvement in diagnosis and management. Assessment of suspected cardiac injuries in a trauma setting is a challenging and time-critical matter, with clinical and imaging findings having complementary roles in the formation of an accurate diagnosis. Cardiac computed tomography and cardiac ultrasound are the two most important diagnostic modalities. Pericardial tamponade and haemothorax were common intra-operative findings. Patients having penetrating cardiac injury presenting with detectable signs of life on arrival to the hospital can be rescued by early surgical intervention. Penetrating cardiac injuries are high-risk, high-mortality injuries considering the outcomes. Therefore, it is important to choose the appropriate incision. In general clinical settings, thoracotomy and median sternotomy are choices of incisions to explore the injury. It is really important to transfer these patients to the nearest facility in time, make sure they get immediate diagnosis and proper resuscitation until they are ready to be taken into the operating room for exploration.

Official Title
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Median Sternotomy in Penetrating Cardiac Trauma Does it Make a Difference?

Conditions
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Trauma Chest

Intervention / Treatment
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* Procedure: median sternotomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: A. Inclusion criteria: Penetrating traumatic cardiac patients. B.age:patients aged from15 to 60 years old. Exclusion Criteria: Patient who arrest immediately when arrived trauma unit. patients with polytrauma patients with chronic medical disease as asthma or ischemic herat disease

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: median sternotomy<br>median sternotomy in penetrating cardiac trauma and hemodynamically unstable patients, does it affect morbidity and mortality. | Procedure: median sternotomy<br>* median sternotomy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time needed to explore heart | To reveal time needed to explore heart in both interventions. | baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain by pain score | Post operative pain complained by patient. | baseline |