Pulmonary Contusion in Mechanically Ventilated Subjects After Severe Trauma.

BACKGROUND: Pulmonary contusions are thought to worsen outcomes. We aimed to evaluate the effects of pulmonary contusion on mechanically ventilated trauma subjects with severe thoracic injuries and hypothesized that contusion would not increase morbidity. METHODS: We conducted a single-center, retro...

Descripción completa

Detalles Bibliográficos
Publicado en:Respiratory Care Vol. 63; no. 8; pp. 950 - 955
Autores principales: Dhar, Sakshi Mathur, Breite, Matthew D., Barnes, Stephen L., Quick, Jacob A.
Formato: CEU research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Aug2018
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130908931&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 130908931
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        00201324
        4GG
      jtl: Respiratory Care
      issn: 00201324
      maglogo: N
    pubinfo:
      dt: Aug2018
      vid: 63
      iid: 8
      pid: 1365
      pub: Mary Ann Liebert, Inc.
      place: New Rochelle, New York
    artinfo:
      ui:
        130908931
        130908931
        130908931
        10.4187/respcare.05952
        130908931
      ppf: 950
      ppct: 5
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Pulmonary Contusion in Mechanically Ventilated Subjects After Severe Trauma.
      aug:
        au:
          Dhar, Sakshi Mathur
          Breite, Matthew D.
          Barnes, Stephen L.
          Quick, Jacob A.
        affil: Division of Acute Care Surgery, Department of Surgery, University of Missouri, Columbia, Missouri
      sug:
        subj:
          Emergency Patients
          Respiration, Artificial
          Trauma Radiography
          Human
          Retrospective Design
          Scales
          Pneumonia, Ventilator-Associated
          Methicillin-Resistant Staphylococcus Aureus
          Pseudomonas Infections
          Respiratory Distress Syndrome, Acute
          Descriptive Statistics
          Data Analysis Software
          T-Tests
          Two-Tailed Test
          Fisher's Exact Test
          Chi Square Test
          Confidence Intervals
          Education, Continuing (Credit)
          Outcome Assessment
      ab: BACKGROUND: Pulmonary contusions are thought to worsen outcomes. We aimed to evaluate the effects of pulmonary contusion on mechanically ventilated trauma subjects with severe thoracic injuries and hypothesized that contusion would not increase morbidity. METHODS: We conducted a single-center, retrospective review of 163 severely injured trauma subjects (injury severity score ≥ 15) with severe thoracic injury (chest abbreviated injury score ≥ 3), who required mechanical ventilation for >24 h at a verified Level 1 trauma center. Subject data were analyzed for those with radiographic documentation of pulmonary contusion and those without. Statistical analysis was performed to determine the effects of coexisting pulmonary contusion in severe thoracic trauma. RESULTS: Pulmonary contusion was present in 91 subjects (55.8%), whereas 72 (44.2%) did not have pulmonary contusions. Mean chest abbreviated injury score (3.54 vs 3.47, P = .53) and mean injury severity score (32.6 vs 30.2, P = .12) were similar. There was no difference in mortality (11 [12.1%] vs 9 [12.5%], P > .99) or length of stay (16.29 d vs 17.29 d, P = .60). Frequency of ventilator-associated pneumonia was comparable (43 [47.3%] vs 32 [44.4%], P = .75). Subjects with contusions were more likely to grow methicillin-sensitive Staphylococcus aureus in culture (33 vs 10, P = .004) as opposed to Pseudomonas aeruginosa in culture (6 vs 13, P = .003). CONCLUSIONS: Overall, no significant differences were noted in mortality, length of stay, or pneumonia rates between severely injured trauma subjects with and without pulmonary contusions.
      pubtype: Academic Journal
      doctype:
        CEU
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N