Acute Respiratory Distress Syndrome in Patients after Blunt Thoracic Trauma: The Influence of Hyperbaric Oxygen Therapy

2003 ◽  
pp. 77-85 ◽  
Author(s):  
Gennady G. Rogatsky ◽  
Edward G. Shifrin ◽  
Avraham Mayevsky
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Thoracic Trauma ◽  
Oxygen Therapy ◽  
Distress Syndrome ◽  
Blunt Thoracic Trauma

scholarly journals Sensitivitas dan Spesifisitas Pain, Incentive Spirometry, Cough Score sebagai Prediktor Acute Respiratory Distress Syndrome pada Pasien dengan Patah Tulang Iga akibat Trauma Tumpul Toraks

e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 446
Author(s):  
Danny K. Rustandi ◽  
Adrian Tangkilisan ◽  
Wega Sukanto ◽  
Elfrida L. Marpaung
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Prospective Cohort ◽  
Thoracic Trauma ◽  
Distress Syndrome ◽  
Rib Fractures ◽  
Blunt Thoracic Trauma ◽  
Specificity And Sensitivity ◽  
Incentive Spirometry

Abstract: Thoracic trauma is one of the most common causes of death in trauma cases due to acute respiratory distress syndrome (ARDS). Definitive diagnosis and rapid identification are challenges in ARDS due to blunt thoracic trauma. The PIC score (pain, incentive spirometry, cough) is used to evaluate and monitor patients during treatment. This study was aimed to assess the specificity and sensitivity of the PIC Score in predicting the occurrence of ARDS in patients with rib fractures due to blunt thoracic trauma. This study used a prospective cohort design with a correlation analysis using data of dependency modeling via R-line copula, ROC curve analysis, and regression analysis. The results showed a total of 25 patients with an average age of 52 years, male sex was predominant (84% vs 16%). On admission, most patients had fractures of three ribs (40%). The PIC score tended to be lower in patients with higher number of rib fractures. The relationship between the PIC score and the PaO2/FiO2 ratio on day 7th of treatment showed a positive correlation, supporting the possibility of using the PIC score to predict ARDS. The sensitivity and specificity of the PIC score in predicting ARDS in blunt thoracic trauma were quite high (sensitivity 80.2% and specificity 80.9%) with an accuracy of 80.9%. In conclusion, the PIC score can predict accurately the occurrence of ARDS in patients with rib fractures due to blunt thoracic trauma.Keywords: blunt thoracic trauma; ARDS; PIC score  Abstrak: Trauma toraks merupakan salah satu penyebab kematian terbanyak dalam kasus trauma acute respiratory distress syndrome (ARDS). Diagnosis pasti dan identifikasi segera merupakan tantangan dalam penanganan ARDS akibat trauma tumpul toraks. PIC score (pain, incentive spirometry, cough) digunakan untuk mengevaluasi dan memonitor pasien selama perawatan. Penelitian ini bertujuan untuk menilai spesifisitas dan sensitivitas PIC score dalam memrediksi terjadinya ARDS pada pasien patah tulang iga akibat trauma tumpul toraks. Pada penelitian ini digunakan rancangan prospective cohort dengan penilaian korelasi analisis menggunakan data hasil pemodelan dependensi via R-line copula, analisis kurva ROC, dan analisis regresi. Hasil penelitian mendapatkan total 25 pasien dengan rerata usia 52 tahun, didominasi oleh laki-laki (84% vs 16%). Saat masuk kebanyakan pasien mengalami patah tulang pada tiga tulang iga (40%). PIC score cenderung lebih rendah pada pasien dengan jumlah patah tulang iga yang lebih banyak. Hubungan antara PIC score dan rasio PaO2/FiO2 pada hari ke-7 perawatan menunjukkan adanya korelasi positif; hal ini mendukung kemungkinan penggunaan PIC score untuk memrediksi ARDS. Sensitivitas dan spesifisitas PIC score dalam memrediksi ARDS pada trauma tumpul toraks cukup tinggi (sensitivitas 80,2% dan spesifisitas 80,9%) dengan akurasi 80,9%. Simpulan penelitian ini ialah PIC score dapat memrediksi terjadinya ARDS secara akurat pada pasien patah tulang iga akibat trauma tumpul toraks.Kata kunci: trauma tumpul toraks; ARDS; PIC score

scholarly journals Thorax Trauma Severity Score sebagai Prediktor Acute Respiratory Distress Syndrome pada Trauma Tumpul Toraks

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Hendry Soesanto ◽  
Adrian Tangkilisan ◽  
Ishak Lahunduitan
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Severity Score ◽  
Thoracic Trauma ◽  
Distress Syndrome ◽  
Trauma Patients ◽  
Blunt Thoracic Trauma ◽  
Trauma Severity ◽  
Thorax Trauma

Abstract: Thoracic trauma is a significant cause of mortality and morbidity. Difficulties in the management of blunt thoracic trauma patients are caused by the late presentation of acute respiratory distress syndrome (ARDS). Thorax trauma severity score (TTSS), introduced by Pape et al. in 2000, includes patient age, physiologic parameters, and thoracic radiological assessment. This study was aimed to assess the ability of TTSS in prediction of the occurence of ARDS in patients with blunt thoracic trauma. Statistical analysis performed was receiver operating characteristic (ROC) curve. In this study, there were 50 blunt thoracic trauma patients (45 males and 5 females), aged ≥18 years old, admitted to Prof. Dr. R. D. Kandou Hospital during August 2016 to July 2017. Patients with penetrating thoracic trauma, history of any lung disease, and blunt thoracic trauma with onset >24 hours were excluded. The patient age range was 18-73 years with a mean of 39.02 years. Overall, 12 patients (24%) developed ARDS, 9 patients (18%) with pulmonary contusion, 20 patients (40%) with rib fracture, 25 patients (50%) with hematothorax, 6 patients (12%) with pneumothorax, and 5 patients (10%) with hypoxemia. TTSS got the most optimal value of sensitivity (100%) and specifity (92.1%) in cut-off point of 6. Conclusion: TTSS can be used as a diagnostic tool to predict ARDS in blunt thoracic trauma.Keywords: thorax trauma severity score, acute respiratory distress syndrome, blunt thoracic traumaAbstrak: Trauma toraks merupakan penyebab mortalitas dan morbiditas yang signifikan. Kesulitan penanganan pasien dengan trauma tumpul toraks disebabkan keterlambatan terdeteksinya acute respiratory distress syndrome (ARDS). Thorax trauma severity score (TTSS) yang diperkenalkan oleh Pape dkk pada tahun 2000 mencakup usia, parameter fisiologik, dan penilaian radiologik toraks. Penelitian ini bertujuan untuk menilai kemampuan TTSS dalam memrediksi kejadian ARDS pada pasien dengan trauma tumpul toraks. Analisis statistik menggunakan receiver operating characteristic (ROC) curve. Dalam studi ini terdapat 50 pasien dengan trauma tumpul toraks (45 laki-laki dan 5 perempuan), berusia ≥18 tahun yang dirawat di RSUP Prof. Dr. R. D. Kandou pada Agustus 2016 s/d Juli 2017. Pasien dengan trauma tembus toraks, riwayat penyakit paru, dan trauma tumpul toraks dengan onset >24 jam tidak diikut sertakan dalam penelitian. Hasil penelitian mendapatkan rentang usia pasien 18-73 tahun dengan rerata 39,02 tahun. Terdapat 12 pasien (24%) dengan ARDS, 9 pasien (18%) dengan kontusio paru, 20 pasien (40%) dengan fraktur kosta, 25 pasien (50%) dengan hematotoraks, 6 pasien (12%) dengan pneumotoraks, dan 5 pasien (10%) dengan hipoksemia. TTSS mendapatkan nilai paling optimal dari sensitivitas (100%) dan spesifitas (92,1%) pada cut-off point 6. Simpulan: TTSS dapat digunakan sebagai alat diagnostik untuk memrediksi kejadian ARDS pada pasien dengan trauma tumpul toraks.Kata kunci: thorax trauma severity score, acute respiratory distress syndrome, trauma tumpul toraks

scholarly journals Liberal or Conservative Oxygen Therapy for Acute Respiratory Distress Syndrome

2020 ◽  
Vol 382 (11) ◽  
pp. 999-1008 ◽  
Author(s):  
Loic Barrot ◽  
Pierre Asfar ◽  
Frederic Mauny ◽  
Hadrien Winiszewski ◽  
Florent Montini ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Oxygen Therapy ◽  
Distress Syndrome

scholarly journals A Fulminant Case of Acute Respiratory Distress Syndrome Associated with Mycoplasma Pneumonia Treated with Nasal High-Flow Oxygen Therapy

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Naoki Kawakami ◽  
Ho Namkoong ◽  
Takanori Ohata ◽  
Shinji Sakaguchi ◽  
Fumitake Saito ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Oxygen Therapy ◽  
Distress Syndrome ◽  
High Flow ◽  
High Flow Oxygen ◽  
Mycoplasma Pneumonia ◽  
Ventilator Management

Introduction. The prognosis of mycoplasma pneumonia in adults is generally favorable, but a few patients show progression to acute respiratory distress syndrome (ARDS). We have described the management of a patient who showed progression of mycoplasma pneumonia to ARDS. Presentation of Case. A 26-year-old male patient with no significant past medical or social history presented with a 5-day history of fever. Following this, he was diagnosed with bacterial pneumonia and treated with tazobactam/piperacillin; however, he showed little clinical improvement with this treatment approach. We diagnosed the patient with mycoplasma pneumonia with an antigen test and treated him with azithromycin and prednisolone. Despite the appropriate antimicrobial therapy, his symptoms worsened and therefore we changed his oxygen therapy from a reservoir mask to nasal high-flow oxygen in addition to minocycline. Consequently, with this treatment, he recovered from severe mycoplasma pneumonia. Discussion. In patients with severe pneumonia who experience respiratory failure, it has been reported that nasal high-flow oxygen therapy is not inferior to noninvasive positive pressure ventilation therapy regarding intubation rate. In this case, induction of nasal high-flow oxygen therapy led to avoidance of ventilator management. This is a valuable case report highlighting the optimal outcome of nasal high-flow oxygen therapy in a fulminant case of acute respiratory distress syndrome. Conclusion. In patients who present with severe mycoplasma pneumonia with respiratory failure, nasal high-flow oxygen therapy can help reduce the needs for ventilator management including intubation.

Analysis of extracorporeal membrane oxygenation in trauma patients with acute respiratory distress syndrome: A case series

2021 ◽  
pp. 039139882098073
Author(s):  
Friederike Weidemann ◽  
Sebastian Decker ◽  
Jelena Epping ◽  
Marcus Örgel ◽  
Christian Krettek ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Sofa Score ◽  
Thoracic Trauma ◽  
Distress Syndrome ◽  
Case Series ◽  
Polytrauma Patients ◽  
Ecmo Therapy

Background: Thoracic trauma is the most common injury in polytrauma patients. Often associated with the development of an acute respiratory distress syndrome (ARDS), conservative treatment options are very restricted and reach their limits quickly. Objective: Extracorporeal membrane oxygenation (ECMO) is a wellestablished therapy in cardio-thoracic surgery and internal medicine intensive care units. The purpose of this study is to analyse the potential benefit of ECMO therapy in ARDS treatment in polytrauma patients. Design: Retrospective case series. Setting: Level 1 trauma centre, Germany, 04/2011-04/2019. Patients: Nineteen patients with ARDS treated with a veno-venous ECMO system. Main outcome measures: This study focused on the time leading to therapy initiation, the severity of thoracic and overall injury. The Sequential Organ Failure Assessment (SOFA) Score, the Murray Score, the Abbreviated Injury Scale (AIS) 2005 level and the Injury Severity Score (ISS) were analysed. The results were analysed regarding survival and death. Results: The survival rate was 53%. The ISS was the same for survivors and deceased patients ( p = 0.604). Early initiation of ECMO therapy showed a significant trend for survivors ( p = 0.071). The SOFA Score level before ECMO therapy was significantly lower in the survivors than in those who died ( p = 0.035). The AISThorax level for survivors showed a significantly higher score level than the one for deceased patients ( p = 0.05). Conclusion: ECMO therapy in polytrauma patients is a safe and effective option, in particular when used early in ARDS treatment. The overall severity of organ failure determined the likelihood of survival rather than the thoracic trauma itself.

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