«De novo thrombosis» of the pulmonary artery after chest trauma

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

The possibility of the formation of thrombosis in the pulmonary artery system «de novo» after a chest injury without connection with thrombosis of the veins of the lower extremities or other localization is considered, and possible pathogenetic mechanisms for the formation of such manifestations are discussed. A clinical case of «de novo thrombosis» in a wounded person after receiving a combat chest injury is presented. The need for a prospective study is substantiated in order to identify coagulation disorders in wounded patients with combat chest trauma and to develop optimal tactics for anticoagulant therapy. «De novo thrombosis» of the pulmonary artery is a pressing problem in patients with chest injuries of various etiologies, including wounded ones. To solve this problem, additional research will be required, among which, along with assessing changes in the hemostatic system, it is necessary to study the optimization of approaches to its treatment using certain groups and regimens of anticoagulant drugs.

Full Text

Restricted Access

About the authors

M. A. Kharitonov

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Author for correspondence.
Email: vmeda-na@mil.ru

профессор, полковник медицинской службы запаса

Russian Federation, St. Petersburg

V. V. Salukhov

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: vmeda-na@mil.ru

профессор, полковник медицинской службы

Russian Federation, St. Petersburg

A. V. Demyanenko

The P.V.Mandryka Central Military Clinical Hospital of the Ministry of Defense of the Russian Federation

Email: vmeda-na@mil.ru

заслуженный врач РФ, кандидат медицинских наук, полковник медицинской службы

Russian Federation, Moscow

N. A. Varavin

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: vmeda-na@mil.ru

майор медицинской службы

Russian Federation, St. Petersburg

V. V. Bezuzhkevich

The S.M.Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation

Email: vmeda-na@mil.ru

подполковник медицинской службы запаса

Russian Federation, St. Petersburg

References

  1. Гончаров А.В., Супрун А.Ю., Маркевич В.Ю. и др. Ушиб легких при огнестрельных ранениях и механических травмах мирного времени // Вестн. Рос. воен.-мед. акад. – 2017. – № 2 (58). – С. 145–151.
  2. Зайцев А.А., Давыдов Д.В., Чуприна А.П. и др. Повреждение грудной клетки // Терапия. – 2023. – Т. 9, № 6 (68). – С. 60–68. doi.org/10.18565/therapy.2023.6.60-68
  3. Закрытая травма грудной клетки: Клин. реком. Минздрава РФ – 2021–2023.
  4. Савушкина О.И., Зайцев А.А., Малашенко М.М. и др. Функциональные нарушения системы дыхания у пациентов с проникающими ранениями легких: дизайн проспективного исследования // Consilium Medicum. – 2022. – Т. 24, № 3. – С. 199–204. https://doi.org/10.26442/20751753.2022.3.201527
  5. Филиппова И.А., Рудь С.Д., Труфанов Г.Е. Усовершенствование методики компьютерной томографии груди у пострадавших с ушибом легких с тяжелой сочетанной травмой // Вестн. Рос. воен.-мед. акад. – 2013. – № 4 (44). – С. 114–118.
  6. Чучалин А.Г., Зайцев А.А., Куликова Н.А. и др. Ушиб легкого: клинические рассуждения // Пульмонология. – 2023. – Т. 33, № 3. – С. 408–413. doi.org/10.18093/0869-0189-2023-33-3-408-413
  7. Aziz H.A., Hileman B.M., Chance E.A. No correlation between lower extremity deep vein thrombosis and pulmonary embolism proportions in trauma: a systematic literature review // Europ. J. of Trauma and Emerg. Surg. – 2018. – Vol. 44, N 6. – P. 843–850. doi: 10.1007/s00068-018-1043-3
  8. Baranga L., Khanuja S., Scott J.A. et al. In Situ Pulmonary Arterial Thrombosis: Literature Review and Clinical Significance of a Distinct Entity. A.J.R. // Am. J. Roentgenol. – 2023. – Vol. 221, N 1. – P. 57–68. https://doi.org/10.2214/AJR.23.28996
  9. Brown I.E., Rigor R.R., Schutzman L.M. Pulmonary arterial thrombosis in a murine model of blunt thoracic trauma // Shock. – 2018. – Vol. 50, N 6. – P. 696–705. doi.org/: 10.1097/SHK.0000000000001109
  10. Cao Y., Geng C., Li Y., Zhang Y. In situ Pulmonary Artery Thrombosis: A Previously Overlooked Disease // Front Pharmacol. – 2021. – Vol. 12. – P. 1–12. doi: 10.3389/fphar. 2021.671589
  11. Knudson M.M., Gomez D., Haas B. et al. Three thousand seven hundred thirty-eight posttraumatic pulmonary emboli: a new look at an old disease // Ann. Surg. – 2011. – Vol. 254, N 4. – P. 625–632. https://doi.org/10.1097/SLA.0b013e3182300209
  12. Marro A., Chan V., Haas B., Ditkofsky N. Blunt chest trauma: classification and management // Emerg. Radiol. – 2019. – Vol. 26, N 5. – P. 557–566. doi: 10.1007/s10140-019-01705-z
  13. Schutzman L.M., Rigor R.R., Khosravi N. P-Selectin Is Critical for De Novo Pulmonary Arterial Thrombosis Following Blunt Thoracic Trauma // J. Trauma Acute Care Surg. – 2019. – Vol. 86, N 4. – P. 583–591. doi.org/10.1097/TA.0000000000002166
  14. Schutzman L.M., Rigor R.R., Lin Y.J. et al. P-selectin antibody treatment after blunt thoracic trauma prevents early pulmonary arterial thrombosis without changes in viscoelastic measurements of coagulation // J. Trauma Acute Care Surg. – 2021. – Vol. 90, N 6. – P. 1032–1039. https://doi.org/10.1097/TA.0000000000003162
  15. Thivaharan Y., Dayapala A., Thanushan M.A. Case of early pulmonary embolism following blunt trauma to chest and a long bone fracture: a case report // Egyptian J. of Forensic Sci. – 2023. – Vol. 13, N 1. – P. 9. https://doi.org/10.1186/s41935-023-00327-4.
  16. Van Gent J.M., Zander A.L., Olson E.J. et al. Pulmonary embolism without deep venous thrombosis: de novo or missed deep venous thrombosis? // J. Trauma Acute Care Surg. – 2014. – Vol. 76, N 5. – P. 1270–1274. doi: 10.1097/TA.0000000000000233
  17. Velmahos G.C., Spaniolas K., Tabbara M. et al. Pulmonary embolism and deep venous thrombosis in trauma: are they related? // Arch. Surg. – 2009. – Vol. 144, N 10. – P. 928–932. doi: 10.1001/archsurg.2009.97

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2024 Kharitonov M.A., Salukhov V.V., Demyanenko A.V., Varavin N.A., Bezuzhkevich V.V.



СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: № 01975 от 30.12.1992.