scholarly journals Predictive Factors of Ventilatory Support in Chest Trauma

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1154
Author(s):  
Silvia Fattori ◽  
Elisa Reitano ◽  
Osvaldo Chiara ◽  
Stefania Cimbanassi

This study aims to define possible predictors of the need of invasive and non-invasive ventilatory support, in addition to predictors of mortality in patients with severe thoracic trauma. Data from 832 patients admitted to our trauma center were collected from 2010 to 2017 and retrospectively analyzed. Demographic data, type of respiratory assistance, chest injuries, trauma scores and outcome were considered. Univariate analysis was performed, and binary logistic regression was applied to significant data. The injury severity score (ISS) and the revised trauma score (RTS) were both found to be predictive factors for invasive ventilation. Multivariate analysis of the anatomical injuries revealed that the association of high-severity thoracic injuries with trauma in other districts is an indicator of the need for orotracheal intubation. From the analysis of physiological parameters, values of systolic blood pressure, lactate, and Glasgow coma scale (GCS) score indicate the need for invasive ventilatory support. Predictive factors for non-invasive ventilation include: RTS, ISS, number of rib fractures and presence of hemothorax. Risk factors for death were: age over 65, the presence of bilateral rib fractures, pulmonary contusion, hemothorax and associated head trauma. In conclusion, the need for invasive ventilatory support in thoracic trauma is associated to the patient’s systemic severity. Non-invasive ventilation is a supportive treatment indicated in physiologically stable patients regardless of the severity of thoracic injury.

2014 ◽  
Vol 31 ◽  
pp. 79
Author(s):  
A. Cherif ◽  
A. Ammous ◽  
Belhaj H. Amor ◽  
M. Louati ◽  
M. Othman ◽  
...  

2019 ◽  
Vol 11 (9) ◽  
pp. 376-380
Author(s):  
Samuel McCreesh

Chronic obstructive pulmonary disease (COPD) is the second most common respiratory illness in the UK, affecting over 1 million people. Acute exacerbations of COPD are a common presentation to the ambulance service and account for thousands of hospital admissions annually. Acute respiratory failure accompanies approximately 20% of exacerbations. Current prehospital treatment focuses on oxygen and pharmacological therapy to treat the underlying causes. Non-invasive ventilation (NIV) is a method of ventilatory support that does not require endotracheal intubation, avoiding significant risks associated with intubation and sedation. While some UK ambulance services have introduced NIV, UK guidelines primarily focus on hospital use. International trials have shown prehospital NIV to be more effective than standard treatment in terms of reducing the need for intubation and invasive ventilation in hospital. However, further research is necessary before NIV is introduced widely in UK prehospital paramedic practice.


2008 ◽  
Vol 34 (9) ◽  
Author(s):  
Etienne Javouhey ◽  
Audrey Barats ◽  
Nathalie Richard ◽  
Didier Stamm ◽  
Daniel Floret

Critical Care ◽  
2012 ◽  
Vol 16 (4) ◽  
pp. 442 ◽  
Author(s):  
Guillaume Lacroix ◽  
Julien Legodec ◽  
Erwan D'Aranda ◽  
Pierre Esnault ◽  
Pierre-Emmanuel Romanat ◽  
...  

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