Prolonged mechanical rib separation is a key element to prevent thoracic compartment syndrome in penetrating chest trauma: A case report

Penetrating cardiac injury in trauma patients is highly morbid. Most cases do not survive long enough to manifest the severe physiologic consequences of massive blood product resuscitation, namely, thoracic compartment syndrome and right ventricular (RV) failure. This case exhibits a thoracic compartment syndrome and RV failure so severe that the open chest management required mechanical separation of a clamshell thoracotomy. The resuscitation and the techniques utilized to maintain an open chest will be described.