scholarly journals Long-term Outcome in Chest Trauma

2008 ◽  
Vol 109 (5) ◽  
pp. 864-871 ◽  
Author(s):  
Marc Leone ◽  
Fabienne Brégeon ◽  
François Antonini ◽  
Kathia Chaumoître ◽  
Aude Charvet ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Chest Trauma ◽  
Computed Tomography Scan ◽  
Walk Distance ◽  
Chest Computed Tomography ◽  
Tomography Scan

Background Currently, there are limited data available describing the long-term outcomes of chest trauma survivors. Here, the authors sought to describe chest trauma survivor outcomes 6 months and 1 yr after discharge from the intensive care unit, paying special attention to pulmonary outcomes. Methods A cohort of 105 multiple trauma patients with blunt chest trauma admitted to the intensive care unit was longitudinally evaluated. After 6 months, a chest computed tomography scan, pulmonary function testing (PFT), and quality of life were collected in 55 of these patients. A subgroup of 38 patients was followed up for 1 yr. Results At least one abnormal PFT result was found in 39 patients (71%). Compared with normalized data of the age- and sex-matched population, physical function was decreased in 38 patients (70%). The 6-min walk distance was reduced for 29 patients (72%). Although pathologic images were observed on the chest computed tomography scan from 33 patients (60%), no relation was found between PFT and computed tomography. A ratio of arterial oxygen pressure to inspired oxygen fraction less than 200 at admission to the intensive care unit predicted an abnormal PFT result at 6 months. One year after discharge from the intensive care unit, paired comparisons showed a significant increase in forced vital capacity (P = 0.02) and Karnofsky Performance Status (P < 0.001). Conclusions Survivors of multiple traumas including chest trauma demonstrate a persistent decrease in the 6-min walk distance, impairment on PFT, and reduced pulmonary-specific quality of life.

Occult Pulmonary Embolism in Intensive Care Unit Patients Undergoing Chest Computed Tomography Scan: Incidence and Effect on Outcomes

2013 ◽  
Vol 27 (3) ◽  
pp. 474-478 ◽  
Author(s):  
Elodie Arnoult ◽  
Sandrine Wiramus ◽  
Julien Textoris ◽  
Fabien Craighero ◽  
Benoit Ragonnet ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Pulmonary Embolism ◽  
Intensive Care ◽  
Computed Tomography Scan ◽  
Chest Computed Tomography ◽  
Tomography Scan

scholarly journals Pneumocephalus and pneumorachis after blunt chest trauma without spinal fractures: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Etienne Allard ◽  
Jean Selim ◽  
Benoit Veber
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Blunt Trauma ◽  
Subcutaneous Emphysema ◽  
Spinal Canal ◽  
Skull Fractures ◽  
Computed Tomography Scan ◽  
Tomography Scan

Abstract Background Pneumocephalus and pneumorachis, presence of air inside the skull and spinal canal, are mostly seen after neurosurgical procedures and neuraxial anesthesia. They have also been described after penetrating trauma, but never after blunt trauma without adjacent bone fractures. Case description We present the case of an 85-year-old white male patient admitted to our intensive care unit after a high velocity car accident. On site clinical evaluation showed normal consciousness with 15/15 Glasgow Coma Scale after a short initial loss of consciousness. The patient was first sent to a nearby hospital where a whole-body computed tomography scan revealed pneumocephalus and pneumorachis and an important left hemopneumothorax with pneumomediastinum with extensive subcutaneous emphysema. The state of the patient quickly worsened with hemorrhagic shock. The patient was sent to our intensive care unit; upon neurosurgical evaluation, no surgical indication was retained due to the absence of skull and spine fracture. A computed tomography scan performed on day 6 showed total regression of the pneumocephalus and pneumorachis. A follow-up computed tomography scan performed on day 30 revealed no intracranial bleeding or stroke, but a left pleural hernia between ribs 5 and 6. Due to respiratory complications, our patient could not be weaned from ventilator support for a proper neurological examination. Our patient’s state finally worsened with septic shock due to ventilator-acquired pneumonia leading to multiple organ failure and our patient died on day 37. Conclusions This is the first case report to describe pneumorachis and pneumocephalus following blunt trauma with pneumothorax, but no spinal or skull fractures. The mechanism that is probably involved here is a migration of air with subcutaneous emphysema and a pleural hernia into the spinal canal. However, in cases of pneumorachis or pneumocephalus, skull fractures need to be investigated as these require surgery and appropriate vaccination to prevent meningitis.

Left Cardiac Luxation Caused by a Blunt Chest Trauma: A Difficult Diagnosis Confirmed on Chest Computed Tomography Scan—Two Case Reports

2010 ◽  
Vol 68 (3) ◽  
pp. E74-E76
Author(s):  
Hervé Quintard ◽  
Emmanuelle Badia ◽  
Raphaëlle Duponq ◽  
Corine Samat-Long ◽  
Nicolas Venissac ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Case Reports ◽  
Computed Tomography Scan ◽  
Chest Computed Tomography ◽  
Difficult Diagnosis ◽  
Tomography Scan

scholarly journals Pulmonary coinfection of Mycobacterium tuberculosis and Tropheryma whipplei: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Binghua Zhu ◽  
Jing Tang ◽  
Rong Fang ◽  
Xuejie Fei ◽  
Qing Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Mycobacterium Tuberculosis ◽  
Next Generation Sequencing ◽  
Tropheryma Whipplei ◽  
Diagnostic Methods ◽  
Next Generation ◽  
Computed Tomography Scan ◽  
Chest Computed Tomography ◽  
Tomography Scan ◽  
Generation Sequencing

Abstract Background We diagnosed a clinical case of pulmonary infection involving Mycobacterium tuberculosis and Tropheryma whipplei in a patient with acute respiratory distress syndrome. The diagnosis was assisted by metagenomic next-generation sequencing of bronchoalveolar lavage fluid. Case presentation A 44-year-old Han Chinese inmate was transferred to the emergency department because of dry cough, chest tightness, and shortness of breath. The patient’s body temperature rose to 39.3 °C following empirical cephalosporin treatment for 1 week. The blood CD4+/CD8+ ratio was 0.7, suggesting immunodeficiency. Routine microbiological tests were performed, and tuberculosis interferon gamma release assays were positive. Mycobacterium tuberculosis polymerase chain reaction was also positive. Chest computed tomography scan revealed miliary nodules and ground-glass opacifications, which were in accordance with tuberculosis. To fully examine the etiology, we performed routine laboratory tests and metagenomic sequencing, the results of which indicated the presence of Mycobacterium tuberculosis and Tropheryma whipplei. We administered anti-tuberculosis regimen in combination with trimethoprim/sulfamethoxazole. The patient recovered, with chest computed tomography scan showing absorption of lesions. Conclusions Compared with traditional diagnostic methods such as culture and serology, metagenomic next-generation sequencing has the advantage of detecting a wide array of microorganisms in a single test and therefore can be used for clinical diagnosis of rare pathogens and microbial coinfections. It is particularly useful for immunocompromised patients as they are more prone to infection by opportunistic microorganisms.

Management of long-term hypothyroidism: a potential marker of quality of medicines reconciliation in the intensive care unit

2012 ◽  
Vol 20 (5) ◽  
pp. 303-306 ◽  
Author(s):  
Nicholas A. Barrett ◽  
Andrew Jones ◽  
Craig Whiteley ◽  
Sarah Yassin ◽  
Cathrine A. McKenzie
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Potential Marker ◽  
Medicines Reconciliation

Effects of prolonged intensive care unit stay on quality of life and long-term survival after transthoracic esophageal resection

2006 ◽  
Vol 34 (2) ◽  
pp. 354-362 ◽  
Author(s):  
H A. Cense ◽  
J B. F. Hulscher ◽  
A G. E. M. de Boer ◽  
D A. Dongelmans ◽  
H W. Tilanus ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Stay ◽  
Esophageal Resection ◽  
Term Survival ◽  
Long Term Survival
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