Traumatic Asphyxia in Children

Introduction:Traumatic asphyxia is a rare clinical syndrome characterized by cervicofacial cyanosis, Ecchymotic or petechial hemorrhages on the upper chest and face, subconjunctival hemorrhage, neurological symptoms, and thoracic injury. Traumatic asphyxia is a consequence of traumatic thoracic or abdominal compression that occurs in children because of the greater flexibility of their thoracic cages. Typically, a marked increase in intrathoracic pressure occurs as the result of direct compression of the chest from crushing injury, in conjunction with deep inspiration against a closed glottis. This increased pressure is transmitted from the right atrium directly through the valveless superior and inferior vena cava, causing rupture of venules and capillaries of the face and head. Hemoptysis, Bloody discharge from the nose and/or ears, Exophthalmos, Vision loss caused by hemorrhage into the retina, vitreous body, or optic nerve, with prolonged compression, neurologic abnormalities such as altered mental status, brachial plexus injuries, quadriplegia (without evidence of spinal cord injury), and coma may manifest in severe cases.Methods: All records at the Namazi hospital pediatric Surgery ward in Shiraz, Iran, were examined over a 10- year period from 2009 to 2019 for all cases of traumatic asphyxia occurring in children under the age of 17 years.Results:Eight children with traumatic asphyxia were evaluated retrospectively. There were five boys and three girls. The mechanism of injuries was motor vehicle accidents in six children. A fall in one patient and compression by lift in one patient. Clinical features of traumatic asphyxia developed in all patients. Five patients were disoriented and consciousness. Associated injuries were noted in all patients often involving thorax and head. Cerebral seizures complicated head injury in one patient. No mortality was recorded.Discussion:Initial management should focus on support of airway, breathing, and circulation and treatment of related injuries. Interventions to reduce intracranial pressure (such as elevating the head of the bed) may be helpful. Although the clinical manifestations of traumatic asphyxia are dramatic, morbidity and mortality are generally related to associated injuries. For children with traumatic asphyxia who survive the initial event, outcomes are generally good. The cutaneous findings and subconjunctival hemorrhages typically resolve and neurologic sequelae are rare.

کلیدواژه ها:

Trauma ، Asphyxia ، Children ،