Prognosis of Pulmonary Function in Patients with Multiple Rib Fractures

Objectives To assess the effect of thoracic paravertebral block (PVB) on pain management and preservation of pulmonary function compared with intravenous, patient-controlled analgesia (IVPCA) in patients with multiple rib fractures (MRFs). Methods Ninety patients with unilateral MRFs were included in this prospective study and randomly assigned to the TPVB or IVPCA group. The visual analogue scale (VAS) pain score, blood gas analysis, and bedside spirometry were measured and recorded at different time points after analgesia. Results TPVB and IVPCA provided good pain relief. VAS scores were significantly lower in the TPVB group than in the IVPCA group at rest and during coughing ( P < 0.05). Patients in the TPVB group had a higher PaO2 and PaO2/FiO2 and lower P(A–a)O2 compared with the IVPCA group ( P < 0.05). Moreover, patients in the TPVB group showed higher FVC, FEV1/FVC, and PEFR, and fewer complications than did the IVPCA group ( P < 0.05). Conclusion TPVB is superior to IVPCA in pain relief and preservation of pulmonary function in patients with MRFs.

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The evaluation of pulmonary function after rib fixation for multiple rib fractures and flail chest: a retrospective study and systematic review of the current evidence

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-019-01274-3 ◽

2019 ◽

Cited By ~ 1

Author(s):

Jesse Peek ◽

Reinier Bart Beks ◽

Valerie Kremo ◽

Nicole van Veelen ◽

Alfred Leiser ◽

...

Keyword(s):

Systematic Review ◽

Retrospective Study ◽

Pulmonary Function ◽

Flail Chest ◽

Rib Fractures ◽

Current Evidence ◽

Multiple Rib Fractures ◽

Rib Fixation

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The Feasibility and Efficiency of Remote Spirometry System on the Pulmonary Function for Multiple Ribs Fracture Patients

Journal of Personalized Medicine ◽

10.3390/jpm11111067 ◽

2021 ◽

Vol 11 (11) ◽

pp. 1067

Author(s):

Chien-An Liao ◽

Tai-Horng Young ◽

Chi-Tung Cheng ◽

Ling-Wei Kuo ◽

Chih-Yuan Fu ◽

...

Keyword(s):

Lung Function ◽

Pulmonary Function ◽

Complication Rate ◽

Rib Fractures ◽

Poor Compliance ◽

Function Parameter ◽

P Value ◽

Good Compliance ◽

Multiple Rib Fractures ◽

The Poor

Background: Multiple rib fractures is a common chest trauma with a significant and sustained impact on pulmonary function and quality of life. Continuous monitoring of the pulmonary function parameter was necessary to adjust the therapeutic goals in these patients. We developed an internet-based remote system for lung function monitoring with a remote spirometry and smart device application to follow up these patients consecutively. Method: From Jan 2021 to April 2021, we conducted a prospective study that applied an intelligent spirometry system for patients with multiple rib fractures. With informed consent, we collected clinical data from them and introduced the remote spirometry system. We followed up with these patients for 12 weeks after trauma and compared the recovery of pulmonary function parameters and clinical outcomes. Result: A total of 21 patients were enrolled in our study. We divided them into two groups by the compliance to this remote spirometry system. The improvement of forced vital capacitywas better in the good compliance group than the poor compliance group (110% versus 21%, p value 0.049). Moreover, the complication rate was also lower in the good compliance group than the poor compliance group (10% versus 66.7% p value 0.017). Conclusion: Remote spirometry system is a novel system that can help in lung rehabilitation in patients with multiple rib fractures. Patients that cooperate well with this system presented superior lung function improvement and inferior complication rate.

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