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The thorax houses vital structures, and even seemingly trivial trauma may result in catastrophic damage particularly in children or older patients. This review aims to highlight important considerations in diagnosis and management of major thoracic injuries and the crucial role of appropriate supportive interventions such as airway control, ventilation strategies and optimal pain management to aid in recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We undertook a narrative review of the contemporary literature. We synthesised evidence related to mechanisms of thoracic trauma and initial assessment and diagnosis of major thoracic injuries. We also highlight key considerations in chest wall, pulmonary, cardiac and diaphragmatic injuries; supportive management strategies for patients with thoracic trauma; and special considerations in older patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thoracic injuries are broadly classified by the mechanism of trauma (blunt, penetrating or blast) or by the anatomical structure involved. Initial assessment and diagnosis follows general trauma principles. Depending on the injuries sustained, surgical intervention may be indicated. Equally important is appropriate supportive management. Older patients are often overlooked as a high\u2010risk group and a lower threshold for specialised trauma care or critical care services is recommended in this cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>A multidisciplinary approach is key in management of patients with thoracic trauma due to their numerous needs, ranging from surgical intervention and critical care support to physiotherapy and rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70284","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T09:42:34Z","timestamp":1783330954000},"page":"1535-1548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of major thoracic trauma: a narrative review"],"prefix":"10.1111","volume":"81","author":[{"given":"Navniel","family":"Kaur","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Mbagathi County Referral Hospital  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Lewis","sequence":"additional","affiliation":[{"name":"Critical Care Department Aintree University Hospital, University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hollie","family":"Jenkinson","sequence":"additional","affiliation":[{"name":"Trauma and Emergency General Surgery Service Aintree University Hospital, University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Keegan","sequence":"additional","affiliation":[{"name":"Department of Radiology Aintree University Hospital, University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Misra","sequence":"additional","affiliation":[{"name":"Trauma and Emergency General Surgery Service Aintree University Hospital, University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Neequaye","sequence":"additional","affiliation":[{"name":"Liverpool Vascular &amp; Endovascular Service Aintree University Hospital, University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Scott","sequence":"additional","affiliation":[{"name":"Cheshire &amp; Mersey Major Trauma Centre Collaborative Aintree University Hospital, University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Astles","sequence":"additional","affiliation":[{"name":"Critical Care Department Aintree University Hospital, University Hospitals of Liverpool Group  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Morton","sequence":"additional","affiliation":[{"name":"Critical Care Department Aintree University Hospital, University Hospitals of Liverpool Group  Liverpool UK"},{"name":"Department of Clinical Sciences Liverpool School of Tropical Medicine, Pembroke Place  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"JainA WaseemM.Chest trauma. 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