دورية أكاديمية
Oxygenation and Respiratory System Compliance Associated With Pulmonary Contusion.
| العنوان: | Oxygenation and Respiratory System Compliance Associated With Pulmonary Contusion. |
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| المؤلفون: | Zingg SW; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., Gomaa D; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., Blakeman TC; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., Rodriquez D; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., Salvator A; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., Goodman MD; Department of Surgery, University of Cincinnati, Cincinnati, Ohio., Janowak CF; Department of Surgery, University of Cincinnati, Cincinnati, Ohio. christopher.janowak@uc.edu. |
| المصدر: | Respiratory care [Respir Care] 2022 Sep; Vol. 67 (9), pp. 1100-1108. Date of Electronic Publication: 2022 Jun 21. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Daedalus Enterprises for the American Association for Respiratory Therapy Country of Publication: United States NLM ID: 7510357 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1943-3654 (Electronic) Linking ISSN: 00201324 NLM ISO Abbreviation: Respir Care Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <1983-> : Dallas, TX : Daedalus Enterprises for the American Association for Respiratory Therapy Original Publication: Philadelphia : Lippincott, c1971- |
| مواضيع طبية MeSH: | Contusions*/etiology , Lung Injury* , Thoracic Injuries*/complications , Wounds, Nonpenetrating*/complications, Humans ; Hypoxia/complications ; Lung |
| مستخلص: | Background: Blunt pulmonary contusions are associated with severe chest injuries and are independently associated with worse outcomes. Previous preclinical studies suggest that contusion progression precipitates poor pulmonary function; however, there are few current clinical data to corroborate this hypothesis. We examined pulmonary dynamics and oxygenation in subjects with pulmonary contusions to evaluate for impaired respiratory function. Methods: A chest injury database was reviewed for pulmonary contusions over 5 years at an urban trauma center. This database was expanded to capture mechanical ventilation parameters for the first 7 days on all patients with pulmonary contusion and who were intubated. Daily [Formula: see text]:[Formula: see text], oxygenation indexes (OI), and dynamic compliances were calculated. Pulmonary contusions were stratified by severity. The Fisher exact and chi square tests were performed on categorical variables, and Mann-Whitney U-tests were performed on continuous variables. Significance was assessed at a level of 0.05. Results a Total of: 1,176 patients presented with pulmonary contusions, of whom, 301 subjects (25.6%) required intubation and had available invasive mechanical ventilation data. Of these, 144 (47.8%) had mild-moderate pulmonary contusion and 157 (52.2%) had severe pulmonary contusion. Overall injury severity score was high, with a median injury severity score of 29 (interquartile range, 22-38). The median duration of mechanical ventilation for mild-moderate pulmonary contusion was 7 d versus 10 d for severe pulmonary contusion ( P = .048). All the subjects displayed moderate hypoxemia, which worsened until day 4-5 after intubation. Severe pulmonary contusion was associated with significantly worse early hypoxia on day 1 and day 2 versus mild-moderate pulmonary contusion. Severe pulmonary contusion also had a higher oxygenation index than mild-moderate pulmonary contusion. This trend persisted after adjustment for other factors, including transfusion and fluid administration. Conclusions: Pulmonary contusions played an important role in the course of subjects who were acutely injured and required mechanical ventilation. Contusions were associated with hypoxemia not fully characterized by [Formula: see text]: [Formula: see text], and severe contusions had durable elevations in the oxygenation index despite confounders. Competing Interests: The authors have disclosed no conflicts of interest. Authors have disclosed no conflicts of interest. (Copyright © 2022 by Daedalus Enterprises.) |
| فهرسة مساهمة: | Keywords: blunt injury; chest injury; pulmonary contusion; trauma; ventilator |
| تواريخ الأحداث: | Date Created: 20220621 Date Completed: 20220826 Latest Revision: 20230322 |
| رمز التحديث: | 20231215 |
| DOI: | 10.4187/respcare.09913 |
| PMID: | 35728821 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1943-3654 |
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| DOI: | 10.4187/respcare.09913 |