mediastina

mediastinal flutter movement of the tissues and organs of the mediastinum back and forth with each movement of air into and out of an open sucking wound in the thoracic cavity. The condition can produce serious impairment of cardiopulmonary function and is fatal if not treated promptly. Symptoms are similar to those of mediastinal shift.

mediastinal shift a shifting or moving of the tissues and organs that comprise the mediastinum (heart, great vessels, trachea, and esophagus) to one side of the chest cavity. The condition occurs when a severe injury to the chest causes the entrapment of air in the pleural space (tension pneumothorax). As the volume of air increases on the affected side, the lung collapses and the organs and tissues of the mediastinum are crowded to the opposite side of the chest. This can produce compression of the other lung and kinking or twisting of one or more of the great blood vessels, which in turn seriously impairs blood flow to and from the heart.

Symptoms of mediastinal shift include severe dyspnea, cyanosis, displacement of the trachea to one side, and distended neck veins. The immediate treatment is insertion of a hollow needle or trocar into the pleural space (thoracentesis) to provide an outlet for the escape of air and fluid. After the trapped air is released, closed chest drainage is initiated to allow for reexpansion of the lung.