Management of traumatic flail chest in intensive care unit: An experience from trauma center ICU

When a patient arrives in an intensive care unit or a trauma center, numerous tests and evaluations lead to a large accumulation of data. A problem that physicians have faced is the following: How does one turn this data into information that can be useful in terms of medical action? Teams of physicians and mathematicians have devoted considerable time and effort to distilling, from as many as sixty different physiological and biochemical variables, those that contain the most useful information.

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Combined external and internal hospital disaster: Impact and response in a Houston trauma center intensive care unit*

Critical Care Medicine ◽

10.1097/01.ccm.0000114995.14120.6d ◽

2004 ◽

Vol 32 (3) ◽

pp. 686-690 ◽

Cited By ~ 52

Author(s):

Joseph L. Nates

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Trauma Center ◽

Disaster Impact

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Colistin-resistant Klebsiella pneumoniae in Surgical Polytrauma Intensive Care Unit of Level-1 Trauma Center: First Case Series from Trauma Patients in India

Indian Journal of Critical Care Medicine ◽

10.4103/ijccm.ijccm_430_17 ◽

2018 ◽

Vol 22 (2) ◽

pp. 103-106 ◽

Cited By ~ 1

Author(s):

Amit Gupta ◽

Subodh Kumar ◽

Neha Rastogi ◽

Sushma Sagar ◽

Purva Mathur

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Klebsiella Pneumoniae ◽

Trauma Center ◽

Case Series ◽

Trauma Patients ◽

First Case ◽

Level 1 ◽

Level 1 Trauma Center

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Concomitant Sternal Fracture in Flail Chest: An Analysis of 21,741 Polytrauma Patients from the TraumaRegister DGU®

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0037-1598194 ◽

2017 ◽

Vol 65 (07) ◽

pp. 551-559 ◽

Cited By ~ 7

Author(s):

Sebastian Krinner ◽

Andreas Langenbach ◽

Pascal Oppel ◽

Rolf Lefering ◽

Dominic Taylor ◽

...

Keyword(s):

Intensive Care Unit ◽

Trauma Center ◽

Injury Severity ◽

Flail Chest ◽

Inclusion Criteria ◽

Sternal Fracture ◽

Spine Injuries ◽

Thorax Trauma ◽

Polytrauma Patients ◽

Sternal Fractures

Background Isolated sternal fractures (SFs) rarely show complications, but their influence in a thorax trauma of the seriously injured still remains unclear. Methods A retrospective analysis of the TraumaRegister DGU® was performed involving the years 2009 to 2013 (Injury Severity Score [ISS] ≥ 16, primary admission to a trauma center). Cohort formation: Unilateral and bilateral flail chest (FC) injuries with and without a concomitant SF, respectively. Results In total, 21,741 patients (25% female) met the inclusion criteria, with 3,492 (16.1%) showing SF. Unilateral FC patients were on average 53.6 ± 18.4 years old, and bilateral FC patients were on average 55.2 ± 17.7 years old. The ISS in unilateral FC and bilateral FC amounted to 31.2 ± 13.0 and 43.4 ± 13.1 points, respectively. FC with an SF occurred more frequently as an injury to car occupants and less frequently as an injury to motorcyclists or in injuries due to falls. Conclusion Patients with an SF additional to an FC had longer hospital and intensive care unit stays and were longer artificially respirated than those patients without an SF. SF indicates possible cardiac and thoracic spine injuries.

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The impact of prehospital management of trauma patients on outcome of ICU treatment at Emergency center CC "Vojvodina" - one - year experience

Acta chirurgica iugoslavica ◽

10.2298/aci1602019p ◽

2016 ◽

Vol 63 (2) ◽

pp. 19-26

Author(s):

Vesna Pajtic ◽

Dunja Mihajlovic ◽

Vladimir Vrsajkov ◽

Aleksandar Gluhovic ◽

Slavko Lovrencic

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Trauma Center ◽

Venous Access ◽

Emergency Center ◽

Prehospital Treatment ◽

Clinical Center ◽

One Year ◽

Injured Patients ◽

The Impact

Impact of prehospital treatment of traumatized patients on treatment outcome in intensive care unit at Emergency center Clinical center of Vojvodina-one year experience Introduction: Trauma is the leading cause of death in 1-44 years old population. Recommendations of prehospital treatment of injured patients rely on the speed of response and transport to referent trauma center, where the patient will be adequately treated. Aim: The aim of our study was to investigate the impact of prehospital treatment and characteristics of patients before admission of patients to Emergency center-Clinical center of Vojvodina on survival of these patients in intensive care unit of Emergency center in order to improve the treatment and outcome of these patients. Material and methods: 209 patients who were treated in intensive care unit after the initial resuscitation in Emergency center-Clinical center of Vojvodina were included in our study. Data were analyzed using SPSS 20.0 software. Differences between groups of patients were assessed by Mann-Whitney U test. Categorical variables were compared using chi-square test. Statistical significance (p) was set at a value of 0.05. Results; Patients with worse outcome were significantly older than patients who had good outcome (49.4?18.5 vs. 63?14.7, p<0.05). Patients with manifestations of hypovolemic shock, respiratory distress and with GCS=8 on admission to Emergency center also had significantly worse outcome. Patients who had been intubated before admission to Emergency center had significantly better outcome in comparison to patients who did not have secured airway (p<0.05). However the placement of venous accessin prehospital setting did not impact survival significantly. Patients who were initially treated in regional hospitals had venous access and airway placement significantly in higher percent than patients treated by emergency medical service. Conclusion: While there is no strong evidence to support the benefits of airway and venous access management in injured patients in prehospital setting, our results suggest that these interventions can be beneficial if the transport to referent trauma center is long and if they are completed by educated medical staff.

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Surgical Approach to Rib Fractures

10.5772/intechopen.98594 ◽

2021 ◽

Author(s):

Turkan Dubus

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Intensive Care Unit Stay ◽

Surgical Approach ◽

Flail Chest ◽

Rib Fractures ◽

Respiratory Problems ◽

Chest Deformity ◽

Intercostal Block

Rib fractures due to thorax trauma are one of the issues that mostly concern thoracic surgeons. Treatment for rib fractures is usually conservative. However, in some cases, fractured rib can cause complicated situations and surgical repair is required. Very serious respiratory problems occur in multiple costa fractures. Therefore, many advantages of surgical stabilization of the thorax wall have been reported. Especially shortening mechanical ventilation, decreasing the duration of intensive care unit stay, is important in preventing complications. Operation indications; Persistent pain despite intercostal block, narcotic and nonsteroidal anti-inflammatory analgesics, It was determined upon the presence of leakage from the thorax tube, intrathoracic hematoma and flail chest deformity. Nowadays, nithinol plates and titanium plates are frequently used in surgeon fixation of the rib fractures.

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