Thoracoabdominal Compression Model of Traumatic Asphyxia to Identify Mechanisms of Respiratory Failure in Fatal Crowd Accidents
| Autor: | Mototsugu Suzuki, Hisashi Matsumoto, Hiroyuki Yokota, Tetsuya Nishimoto, Tomokazu Motomura, Sadayuki Ujihashi |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Traumatic asphyxia Respiratory rate business.industry Respiration Vital Capacity General Medicine medicine.disease Respiratory Muscles Asphyxia Blood pressure Respiratory failure Accidents Internal medicine Heart rate Respiratory muscle medicine Breathing Cardiology Humans Female Respiratory Insufficiency business Tidal volume |
| Zdroj: | Journal of Nippon Medical School. 86:310-321 |
| ISSN: | 1347-3409 1345-4676 |
| Popis: | BACKGROUND Traumatic asphyxia is a major cause of death in fatal crowd disasters, but the relationships between compression site, load magnitude, load time, and medical outcomes are unclear. This study estimated thoracoabdominal compression conditions (load magnitude, load time) that could result in respiratory failure in adults. METHODS Eight load patterns-A (chest load: 0 kg, abdominal load: 10 kg), B (0, 20), C (10, 0), D (10, 10), E (10, 20), F (20, 0), G (20, 10), and H (20, 20)-were applied to 14 healthy women. Blood pressure, heart rate, respiratory rate, SpO2, tidal volume, vital capacity, respiratory phase, and modified Borg dyspnea score were measured over time. Breathing Intolerance Index (BITI) was also calculated. RESULTS Vital capacity decreased in patterns C, D, E, F, G, and H. BITI reached the critical range of ≥0.15 (at which respiratory failure occurs after about 45 min) after 14 min in pattern G and 2 min in pattern H. A vital capacity ≤1.85 L and a modified Borg scale score ≥8.3 corresponded to a BITI of ≥0.15 and were regarded as equivalent to reaching the critical range. Furthermore, change in chest load was positively correlated with BITI when abdominal load remained constant. CONCLUSIONS In women, respiratory failure can occur within 1 h from respiratory muscle fatigue, even when total thoracoabdominal load is only about 60% of body weight. A vital capacity ≤1.85 L and modified Borg scale score ≥8.3 can be regarded as indices for predicting respiratory failure. |
| Databáze: | OpenAIRE |
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