Clinical study on VATS combined mechanical ventilation treatment of ARDS secondary to severe chest trauma

Qi, Yu

doi:10.3892/etm.2016.3355

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…Its value in persistent nonmajor-vessel-bleeding haemothorax in terms of pleural space debridement is undisputable (24). In some cases VATS is considered to be related to lower ARDS-rates in comparison to open thoracotomy patients, whereby an obvious bias for the non-massive-injury-patients exist (25). Yu et al demonstrated in 2016 a small series of VATStreated patients with penetrating thoracic trauma (26).…”

Section: Surgical Trauma Life Supportmentioning

confidence: 99%

Management of chest trauma

Ludwig¹,

Koryllos²

2017

J. Thorac. Dis.

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Trauma is the leading cause of death worldwide. Approximately 2/3 of the patients have a chest trauma with varying severity from a simple rib fracture to penetrating injury of the heart or tracheobronchial disruption. Blunt chest trauma is most common with 90% incidence, of which less than 10% require surgical intervention of any kind. Mortality is second highest after head injury, which underlines the importance of initial management. Many of these deaths can be prevented by prompt diagnosis and treatment. What is the role of the thoracic surgeon in the management of chest trauma in severely injured patients? When should the thoracic surgeon be involved? Is there a place for minimal invasive surgery in the management of severely injured patients? With two case reports we would like to demonstrate how the very specific knowledge of thoracic surgeons could help in the care of trauma patients.

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Section: Surgical Trauma Life Supportmentioning

confidence: 99%

Management of chest trauma

Ludwig¹,

Koryllos²

2017

J. Thorac. Dis.

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“…The results of this study showed that lung-protective ventilation therapy was more advantageous in improving oxygenation indices and protecting lung function in patients suffering from thoracic trauma combined with ARDS, and was able to reduce the duration of mechanical ventilation and the incidence of VALI in patients with a very low morbidity and mortality rate. At the present stage, ventilator-assisted ventilation is often used to treat patients with Thoracic trauma combined with ARDS on the basis of symptomatic treatment, which can precisely control oxygen therapy to avoid ventilator fatigue and obtain satisfactory treatment results ( 23 ). For the traditional conventional ventilation in clinical practice, patients are subjected to high airway pressure due to the large ventilation volume, which predisposes them to lung air pressure injury and thus has a serious impact on their prognosis.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Analysis of Thoracic Trauma Complicated With Acute Respiratory Distress Syndrome and Observation of Curative Effect of Lung-Protective Ventilation

Dong

Wang

et al. 2022

Front. Surg.

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PurposeTo explore the risk factors of acute respiratory distress syndrome (ARDS) secondary to thoracic trauma and the therapeutic effect of protective lung ventilation in patients with acute respiratory distress syndrome complicated with thoracic trauma.MethodsWe collected 206 patients with thoracic trauma admitted to our hospital from September 2017 to March 2021, counted the incidence of ARDS and analyzed the risk factors of ARDS. To observe the clinical efficacy of the application of lung-protective ventilation therapy in patients with thoracic trauma combined with ARDS.ResultsAmong 206 patients with thoracic trauma, there were 82 cases of combined ARDS, and its incidence was 39.81%. The 82 patients with ARDS were randomly divided into the control group and the observation group with 42 cases each, and different ventilation methods were used for treatment. The results showed that the mechanical ventilation time (MVT) was shorter in the observation group than in the control group, and the incidence of ventilator-associated lung injury (VALI) and case fatality rate (CFR) were lower than those in the control group (P < 0.05). Arterial partial pressure of oxygen (Pa02), arterial blood carbon dioxide partial pressure (PaCO2), and Oxygenation index (arterial partial pressure of oxygen/Fraction of inspiration O2, PaO2/FiO2) were significantly improved better in both groups after treatment; compared with the control group, patients in the observation group had higher Pa02 levels and lower PaCO2 levels at 8 h and 24 h after ventilation (P < 0.05). Multivariate analysis revealed that blunt trauma, massive blood transfusion, procalcitonin (PCT) level, tumor necrosis factor-α (TNF-α) level, and acute physiology and chronic health score (APACHE II) were all risk factors for Thoracic trauma with ARDS.ConclusionRisk factors for the development of ARDS after thoracic trauma are blunt injuries, massive blood transfusion, high PCT and TNF-α levels, and high APACHE II scores, which can be given active interventions in the early stage of clinical practice to improve patient prognosis. The use of protective lung ventilation therapy can improve the clinical outcome of patients with thoracic trauma combined with ARDS, which is important for improving the ventilation effect and respiratory function of patients.

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“…In cases with respiratory distress and hypoxia due to the flail segment, endotracheal intubation and mechanical ventilation are necessary, particularly in patients with large pulmonary contusion. Currently, there is an increasing tendency to concentrate on the associated damage to the underlying lung in the form of pulmonary contusion and ARDS [15]. Internal stabilization by means of endotracheal intubation and mechanical ventilation are effective therapeutic options in patients with bilateral multiple rib fractures.…”

Section: Massive Haemothoraxmentioning

confidence: 99%