scholarly journals Assisted respiration using CPAP via face-mask in patients with blunt chest trauma. An alternative to intubation and mechanical ventilation

1998 ◽  
Vol 101 (7) ◽  
pp. 527-536 ◽  
Author(s):  
M. Walz ◽  
G. Möllenhoff ◽  
G. Muhr
Keyword(s):  
Mechanical Ventilation ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Face Mask ◽  
Assisted Respiration

scholarly journals Patterns of invasive mechanical ventilation in patients with severe blunt chest trauma and lung contusion: A French multicentric evaluation of practices

2018 ◽  
Vol 20 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Bertrand Prunet ◽  
Jérémy Bourenne ◽  
Jean-Stéphane David ◽  
Pierre Bouzat ◽  
Mathieu Boutonnet ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Early Onset ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Distress Syndrome ◽  
Invasive Mechanical Ventilation ◽  
Lung Contusion

Introduction This study investigated invasive mechanical ventilation modalities used in severe blunt chest trauma patients with pulmonary contusion. Occurrence, risk factors, and outcomes of early onset acute respiratory distress syndrome were also evaluated. Methods We performed a retrospective multicenter observational study including 115 adult patients hospitalized in six level 1 trauma intensive care units between April and September of 2014. Independent predictors of early onset acute respiratory distress syndrome were determined by multiple logistic regression analysis based on clinical characteristics and initial management. Results Protective ventilation principles were highly implemented, even prophylactically before acute respiratory distress syndrome occurrence. Early onset acute respiratory distress syndrome appeared to be associated with lung contusion of >20% of total lung volume and early onset pneumonia. Conclusions Predictors of early onset acute respiratory distress syndrome could help with identifying high-risk populations, potentially improving case management through specific protocol development for these patients.

scholarly journals Conservative management of Occult Hemothorax in trauma patients requiring assisted ventilation: An observational descriptive study

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Ismail Mahmood ◽  
Khalid Ahmed ◽  
Fuad Mustafa ◽  
Zahoor Ahmed ◽  
Syed Nabir ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Conservative Management ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Assisted Ventilation ◽  
Tube Thoracostomy ◽  
Trauma Patients ◽  
Respiratory Compromise ◽  
Mechanically Ventilated

Background: Traumatic hemothorax is a common consequence of blunt chest trauma. A hemothorax that is missed by initial chest X-ray, but diagnosed by computed tomography (CT), is known as an occult hemothorax. The present study aims at investigating the clinical outcomes of conservative management of occult hemothorax in mechanically ventilated trauma patients. Methods: A retrospective study of all adult blunt chest trauma patients with occult hemothorax requiring mechanical ventilation in a level 1 trauma center was conducted (2010- 2017). Data were obtained from the trauma registry and electronic medical records. Patients were categorized into (a) successful conservative treatment group, and (b) tube thoracostomy group. Results: During the study period, 78 blunt chest trauma patients who had occult hemothorax required mechanical ventilation. Occult hemothorax was managed conservatively in 69% of the patients, while 31% underwent tube thoracostomy. The main indication for tube thoracostomy was the progression of hemothorax on follow-up chest radiographs. Comparison between groups showed that pulmonary contusions (59% vs. 83%), bilateral hemothorax (26% vs. 58%) and chest infections (9% vs. 29%) were lower in conservatively treated group (p < 0.05). Length of stays in ICU and hospital were also lower (p < 0.05). Longer duration of mechanical ventilation and maximum PEEP were significantly associated with tube thoracostomy. Overall mortality was 12% and was comparable between groups. Conclusion: Mechanically ventilated patients with occult hemothorax following blunt chest trauma can be managed conservatively without tube thoracostomy. Tube thoracostomy can be restricted to patients who had evidence of progression of hemothorax on follow-up or developed respiratory compromise.

Risk Factors Associated with Venous Thromboembolism in Isolated Blunt Chest Trauma

2013 ◽  
Vol 79 (5) ◽  
pp. 502-505 ◽  
Author(s):  
Steven A. Kahn ◽  
Heidi Schubmehl ◽  
Nicole A. Stassen ◽  
Ayodele Sangosanya ◽  
Julius D. Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Venous Thromboembolism ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Injury Severity ◽  
Aortic Injury ◽  
Chest Injury ◽  
Hospital Length Of Stay ◽  
Thoracic Injury

Isolated chest trauma is not historically considered to be a major risk factor for venous thromboembolism (VTE). After blunt chest trauma, VTE may be underappreciated because pain, immobility, and inadequate prophylaxis as a result of hemorrhage risk may all increase the risk of VTE. This investigation determines the predictors and rate of VTE after isolated blunt chest trauma. A review of patients admitted to a Level I trauma center with chest trauma between 2007 and 2009 was performed. Demographics, injuries, VTE occurrence, prophylaxis, comorbidities, Injury Severity Score, intensive care unit/hospital length of stay, chest tube, and mechanical ventilation use were recorded. VTE rate was compared between those with isolated chest injury and those with chest injury plus extrathoracic injury. Predictors of VTE were determined with regression analysis. Three hundred seventy patients had isolated chest trauma. The incidence of VTE was 5.4 per cent (n = 20). The VTE rate in those with chest injury plus extrathoracic injury was not significantly different, 4.8 per cent (n = 56 of 1140, P = 0.58). Independent risk factors for VTE after isolated chest trauma were aortic injury ( P < 0.01, odds ratio [OR], 47.7), mechanical ventilation ( P < 0.01; OR, 6.8), more than seven rib fractures ( P < 0.01; OR, 6.1), hemothorax ( P < 0.05; OR, 3.9), hypercoagulable state ( P < 0.05; OR, 6.3), and age older than 65 years ( P < 0.05; OR, 1.03). Patients with the risk factors mentioned are at risk for VTE despite only having thoracic injury and might benefit from more aggressive surveillance and prophylaxis.

scholarly journals The Use Extracorporeal Membrane Oxygenation Therapy in a Severe Blunt Chest Trauma with a Main Tracheal Injury

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Zhang J ◽  
◽  
Han H ◽  
Liu H ◽  
Li Y ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Extracorporeal Membrane Oxygenation ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Main Bronchus ◽  
Tension Pneumothorax ◽  
Trauma Patients ◽  
Left Main ◽  
Membrane Oxygenation ◽  
Vv Ecmo

Major tracheobronchial trauma by blunt chest trauma is high mortality rates worldwide. The use conventional mechanical ventilation in a tension pneumothorax patient by major tracheobronchial trauma has been ineffective with barotrauma. However, the application of Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) in trauma patients has been controversial, but VV-ECMO plays a crucial role when conventional management has failed. VV-ECMO provides adequate tissue oxygenation and an opportunity for recovery. Neither ECMO-associated bleeding nor clotting of the extracorporeal circuit is an upmost for trauma patients. We report a case of previously healthy 16-year-old man with left main bronchial rupture after vehicular accident, who had progressive dyspnea and left tension pneumothorax. After the chest tube drainage, double-lumen endotracheal intubation and mechanical ventilation initiation, severe respiratory distress kept on deterioration. On VV-ECMO transfer to our hospital, we performed emergency thoracotomy and identified the rupture of the left main bronchus. After operation, the patient’s condition improved. VV-ECMO and mechanical ventilation were stopped on days 8 and 9, respectively. He was discharged without complications from the ICU on day 20.

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