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Predictive Factors of Ventilatory Support in Chest Trauma

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 analyz...

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Autores principales: Fattori, Silvia, Reitano, Elisa, Chiara, Osvaldo, Cimbanassi, Stefania
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8621668/
https://www.ncbi.nlm.nih.gov/pubmed/34833030
http://dx.doi.org/10.3390/life11111154
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author Fattori, Silvia
Reitano, Elisa
Chiara, Osvaldo
Cimbanassi, Stefania
author_facet Fattori, Silvia
Reitano, Elisa
Chiara, Osvaldo
Cimbanassi, Stefania
author_sort Fattori, Silvia
collection PubMed
description 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.
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spelling pubmed-86216682021-11-27 Predictive Factors of Ventilatory Support in Chest Trauma Fattori, Silvia Reitano, Elisa Chiara, Osvaldo Cimbanassi, Stefania Life (Basel) Article 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. MDPI 2021-10-29 /pmc/articles/PMC8621668/ /pubmed/34833030 http://dx.doi.org/10.3390/life11111154 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fattori, Silvia
Reitano, Elisa
Chiara, Osvaldo
Cimbanassi, Stefania
Predictive Factors of Ventilatory Support in Chest Trauma
title Predictive Factors of Ventilatory Support in Chest Trauma
title_full Predictive Factors of Ventilatory Support in Chest Trauma
title_fullStr Predictive Factors of Ventilatory Support in Chest Trauma
title_full_unstemmed Predictive Factors of Ventilatory Support in Chest Trauma
title_short Predictive Factors of Ventilatory Support in Chest Trauma
title_sort predictive factors of ventilatory support in chest trauma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8621668/
https://www.ncbi.nlm.nih.gov/pubmed/34833030
http://dx.doi.org/10.3390/life11111154
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