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

Background/Aim: The thoracic injury and related complications are responsible for upto 25% of blunt trauma mortality. This study is designed to compare these two popular ventilation modes in traumatic flail chest. Materials and Method: A total of 30 patients with thoracic trauma, aged 18-60 years, w...

Full description

Saved in:
Bibliographic Details
Published in:Saudi journal of anaesthesia 2019-07, Vol.13 (3), p.179-183
Main Authors: Mishra, Shashi, Mishra, Manjaree, Bano, Noor, Hakim, Mohammad
Format: Article
Language:English
Subjects:
Anesthesia
Blunt trauma
Chest trauma
flail chest
ICU
rib fracture
ventilation
Contusions
Critical care
Intensive care
Intubation
Mortality
Older people
Original
Pain
Patients
Pneumonia
Respiration
Thorax
Trauma
Ventilators
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background/Aim: The thoracic injury and related complications are responsible for upto 25% of blunt trauma mortality. This study is designed to compare these two popular ventilation modes in traumatic flail chest. Materials and Method: A total of 30 patients with thoracic trauma, aged 18-60 years, were enrolled in this study for a period of 1 year. The Thoracic Trauma Severity Score (TTSS) was used for assessing the severity of chest injury. Patients were divided into two treatment groups: one recieved endotracheal intubation with mechanical ventilation (ET group, n = 15) and another recieved noninvasive ventilation (NIV group, n = 15). All patients were observed for the duration of ventilatory days, complications such as pneumonia and sepsis, length of the stay in ICU, and mortality. Statistical analysis was done using statistical software SPSS for windows (Version 16.0). Results: There were no significant differences in age, sex, weight, and length of the stay in ICU in between the two groups. Rate of complications was significantly higher in ET group. Oxygenation was significantly improved in NIV group within 24 hr, later it become equivalent to the ET group patients while the pCO2level was significantly lower in ET group compared with NIV group. Analgesia in both the groups is maintained to keep the visual analog scale (VAS) score below 2 and was comparable in both the groups. Conclusions: The endotracheal intubation is also associated with serious complications as compared to NIV. The use of NIV in appropriate patients decreases complications, mortality, length of the stay in ICU, the use of resources, and cost.
ISSN:1658-354X
0975-3125
DOI:10.4103/sja.SJA_699_18