Prevalence of large and occult pneumothoraces in patients with severe blunt trauma upon hospital admission: experience of 526 cases in a French level 1 trauma center

Charbit, Jonathan; Millet, Ingrid; Maury, Camille; Conte, Benjamin; Roustan, Jean‐Paul; Taourel, Patrice; Capdevila, Xavier

doi:10.1016/j.ajem.2015.03.057

Cited by 11 publications

(9 citation statements)

References 33 publications

(48 reference statements)

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“…The observed size and rate of accumulation of occult pneumothorax was not affected by the use of early mechanical ventilation. (20) In a prospective observational study that included all blunt chest trauma patients requiring positive pressure ventilation, a majority of occult pneumothorax or haemothorax patients were carefully managed without tube thoracostomy. (21) Studies have suggested that tube thoracostomy can be restricted to patients who had increased size of occult pneumothorax or haemothorax or to those who developed respiratory compromise.…”

Section: Discussionmentioning

confidence: 99%

Management of computed tomography-detected pneumothorax in patients with blunt trauma: experience from a community-based hospital

Hefny¹,

Kunhivalappil²,

Matev³

et al. 2018

smedj

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Section: Discussionmentioning

confidence: 99%

Management of computed tomography-detected pneumothorax in patients with blunt trauma: experience from a community-based hospital

Hefny¹,

Kunhivalappil²,

Matev³

et al. 2018

smedj

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“…They also indicated that PTx was a significant factor for survival in patients with MV. Charbit et al [3] reported that 47.0% of patients with PTx after BCT were intubated and followed up with MV. Chrysou et al [8] reported that intubation and MV had been necessary for 29.1% (32 in 110 patients) of polytrauma patients with BCT.…”

Section: Discussionmentioning

confidence: 99%

A pathology not be overlooked in blunt chest trauma: Analysis of 181 patients with bilateral pneumothorax

Özdil

Kavurmacı²,

Akçam³

et al. 2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Bilateral pneumothorax (BPTx) can become tension PTx and a cause of mortality, especially in severe multi-trauma patients. The purpose of this study was to analyze the incidence, morbidity, mortality, and associated factors of BPTx in multi-trauma patients in order to highlight the importance of the management of these cases, as well as complications, morbidity, and mortality. METHODS: The data of 181 patients with BPTx, from a total of 3782 trauma patients, were reviewed retrospectively. The details recorded were age, gender, mechanism of trauma, radiological findings, co-existing thoracic and extra-thoracic injuries, incidence of intubation, mortality, and injury severity score (ISS). The association between laterality of rib fracture, hemothorax, subcutaneous emphysema, and BPTx, and the effect of age and gender on these injuries, mortality, and ISS were analyzed. RESULTS: The patient group included 144 males, and the mean age was 36.07±15.77 years. The primary cause of trauma was a motor vehicle accident, seen in 67 (37.0%) patients. Bilateral rib fractures were detected in 75 (41.4%) patients. Hemothorax accompanied PTx in 41 (22.6%) patients bilaterally. The laterality of the rib fracture and hemothorax demonstrated a significant difference in the patient group over 60 years of age (p=0.017, p=0.005). Co-existing bilateral thoracic injuries were detected more often in this group. Twelve (17.6%) patients with only blunt chest trauma and 56 (82.4%) patients with multi-trauma were intubated. The difference between the 2 groups was not significant (p=0.532). The overall mortality rate was 18.2%. A comparison of ISS and mortality between the groups revealed no significant difference (p=0.22). CONCLUSION: The incidence of BPTx after multi-trauma is approximately 5%, so it must be taken into consideration, especially in severe multi-trauma patients, to reduce mortality. Older age and the number of rib fractures were determined to be risk factors for morbidity and mortality in trauma with BPTx.

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“…37 In another study, 69% of pneumothoraces were occult on XR. 38 The American College of Radiology 39 appropriateness criteria for C-spine trauma no longer indicate XR as a first line test because of its limited sensitivity and specificity. XR plays no role in patients with head or abdominal trauma because injuries to parenchymal organs such as the brain or liver cannot be diagnosed.…”

Section: Radiographymentioning

confidence: 99%

Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

Berger¹,

Körner²,

Bernstein³

et al. 2016

BJR

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In the setting of mass casualty incidents (MCIs), hospitals need to divert from normal routine to delivering the best possible care to the largest number of victims. This should be accomplished by activating an established hospital disaster management plan (DMP) known to all staff through prior training drills. Over the recent decades, imaging has increasingly been used to evaluate critically ill patients. It can also be used to increase the accuracy of triaging MCI victims, since overtriage (falsely higher triage category) and undertriage (falsely lower triage category) can severely impact resource availability and mortality rates, respectively. This article emphasizes the importance of including the radiology department in hospital preparations for a MCI and highlights factors expected to influence performance during hospital DMP activation including issues pertinent to effective simulation, such as establishing proper learning objectives. After-action reviews including performance evaluation and debriefing on issues are invaluable following simulation drills and DMP activation, in order to improve subsequent preparedness. Historically, most hospital DMPs have not adequately included radiology department operations, and they have not or to a little extent been integrated in the DMP activation simulation. This article aims to increase awareness of the need for radiology department engagement in order to increase radiology department preparedness for DMP activation after a MCI occurs.

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Prevalence of large and occult pneumothoraces in patients with severe blunt trauma upon hospital admission: experience of 526 cases in a French level 1 trauma center

Cited by 11 publications

References 33 publications

Management of computed tomography-detected pneumothorax in patients with blunt trauma: experience from a community-based hospital

Management of computed tomography-detected pneumothorax in patients with blunt trauma: experience from a community-based hospital

A pathology not be overlooked in blunt chest trauma: Analysis of 181 patients with bilateral pneumothorax

Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

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