Advertisment Fosfocin
Indian Journal of Critical Care Medicine
An open access publication of ISCCM™ 
 
Users online: 156 
     Home | Login 
  About Current Issue Archive Search Instructions Online Submission Subscribe Etcetera Contact  
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed19596    
    Printed440    
    Emailed22    
    PDF Downloaded764    
    Comments [Add]    
    Cited by others 1    

Recommend this journal

 

 ORIGINAL ARTICLE
Year : 2004  |  Volume : 8  |  Issue : 2  |  Page : 73--77

Outcome in patients with blunt chest trauma and pulmonary contusions


1 Department of Anesthesiology and Critical Care, Sri Ramachandra Medical College and Research Institute, Chennai, India
2 Department of Anesthesiology & Critical Care, Sri Ramachandra Medical College & Research Institute (Deemed University), Chennai, India

Correspondence Address:
V Kamat
Department of Anesthesiology & Critical Care, Sri Ramachandra Medical College & Research Institute (Deemed University), Chennai
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions

ABSTRACT: Severe pulmonary contusions occur in blunt chest trauma, especially with high velocity injuries. Pulmonary contusions following trauma may result in significant hypoxemia and decreased compliance which may progress over several days. Extensive contusions may result in respiratory difficulty or progress to adult respiratory distress syndrome, which increases mortality. We decided to review the cases of polytrauma with associated pulmonary contusions to determine the factors which influence outcome. MATERIALS AND METHODS: A retrospective chart review of all cases of trauma with pulmonary contusions on X-ray or CT scan. The cases were examined for age, type of injuries, admission APACHE II, SAPS II and SOFA scores, PaO2/FiO2 ratio, presence or absence of rib fractures, average positive fluid balance, average sedation dose, pulmonary haemorrhage, ventilator days, ICU days and hospital outcome. RESULTS: There were 18 cases of pulmonary contusions. All had associated injuries. 6 patients died, 4 in the ICU and 2 patients died 1 week after transfer to a high dependency unit, one due to sepsis and the other due to massive haemothorax. There was a significant difference in PaO2/FiO2 ratio at admission and throughout the ICU course, fluid balance and sedation dose, but not in ventilator days and ICU days between survivors and nonsurvivors. The incidence, frequency and amount of pulmonary haemorrhage were higher in the nonsurvivors. CONCLUSIONS: Close attention to improving gas exchange, and early management of hemoptysis might improve outcome in pulmonary contusions






[FULL TEXT] [PDF]*


        
Print this article     Email this article

Online since 7th April '04
Published by Wolters Kluwer - Medknow