Predictive Factors of Ventilatory Support in Chest Trauma
| Autor: | Stefania Cimbanassi, Osvaldo Chiara, Elisa Reitano, Silvia Fattori |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Science
General Biochemistry Genetics and Molecular Biology Article Head trauma invasive ventilation chest trauma medicine Ecology Evolution Behavior and Systematics Univariate analysis business.industry non-invasive ventilation Trauma center Glasgow Coma Scale Paleontology Revised Trauma Score Hemothorax medicine.disease Pulmonary contusion trauma Space and Planetary Science Anesthesia thorax injury outcome Injury Severity Score business |
| Zdroj: | Life Volume 11 Issue 11 Life, Vol 11, Iss 1154, p 1154 (2021) |
| ISSN: | 2075-1729 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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