Key result
Left anterolateral thoracotomy remains the preferred approach for pericardial decompression in traumatic cardiac arrest.
Why the study?
Acute traumatic cardiac tamponade is a time-critical cause of circulatory collapse requiring emergency pericardial decompression often performed by emergency medical staff before surgical teams are available.
A structured approach utilizing ultrasound and immediate decompression via left anterolateral thoracotomy, or temporizing needle pericardiocentesis, is critical for survival in acute traumatic cardiac tamponade.
May support left anterolateral thoracotomy in refractory traumatic tamponade; confirms consensus yet leaves open prospective validation.
Acute traumatic cardiac tamponade is a time-critical-but potentially reversible-cause of circulatory collapse. The surgical, operative, nursing and anaesthesiology staff most capable and best trained to perform the procedure are often not immediately available, requiring emergency medical staff to perform this life-saving intervention. When tamponade causes refractory shock or peri-arrest, left anterolateral thoracotomy remains the preferred technique for definitive pericardial decompression, with extension to a clamshell thoracotomy when required.
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Fitzgerald et al. (2026) conducted a review in Acute traumatic cardiac tamponade. Pericardial decompression (Left anterolateral or Clamshell thoracotomy) was evaluated. Left anterolateral thoracotomy remains the preferred technique for definitive pericardial decompression in acute traumatic cardiac tamponade causing refractory shock or peri-arrest.
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