Should we follow ATLS® guidelines for the management of traumatic pulmonary contusion: the role of non-invasive ventilatory support
Objective: To assess the management of patients with blunt traumatic pulmonary contusion admitted to our hospital. To identify the role of early blood gas analysis, non-invasive ventilation and to assess the validity of the current Advanced Trauma Life Support® manual statement that “Patients with s...
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| Veröffentlicht in: | Resuscitation 2002-03, Vol.52 (3), p.265-268 |
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| creator | Vidhani, Kim Kause, Julianne Parr, Michael |
| description | Objective: To assess the management of patients with blunt traumatic pulmonary contusion admitted to our hospital. To identify the role of early blood gas analysis, non-invasive ventilation and to assess the validity of the current Advanced Trauma Life Support® manual statement that “Patients with significant hypoxia, i.e. PaO
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71562968</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0300957201004750</els_id><sourcerecordid>71562968</sourcerecordid><originalsourceid>FETCH-LOGICAL-c391t-5524de4aa564dcc248e3d7d8690f84621b7c85cab73fcfab7007fc0fb857a8503</originalsourceid><addsrcrecordid>eNqFkMtu1DAUhi0EokPhEUDegGAROE7i2OkGVRU3aSQWU9aWxzlujRw72M5U7HkeHoInI3MRXbI6i_P95_IR8pzBWwase7eBBqDquahfA3sD0ApewQOyYlI0FeMCHpLVP-SMPMn5OwA0vBePyRljUnaiYSvya3MbZz_QO6Q2eh_v6OX1evPnN72Z3YDeBcxLI9Fyi3TUQd_giKHQaGlJeh51cYZOsx9j0OknNTGUObsYLg6BFD3u0RBD5cJOZ7dDulvyzusSFz7P0xRTeUoeWe0zPjvVc_Lt44frq8_V-uunL1eX68o0PSsV53U7YKs179rBmLqV2AxikF0PVrZdzbbCSG70VjTW2KUACGvAbiUXWnJozsmr49wpxR8z5qJGlw16rwPGOSvBeFf3nVxAfgRNijkntGpKblw-VAzUXr866Fd7twqYOuhX-wUvTgvm7YjDferkewFengCdjfY26WBcvuca3nZdWy_c-yOHi46dw6SycRgMDi6hKWqI7j-n_AV4cqUq</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71562968</pqid></control><display><type>article</type><title>Should we follow ATLS® guidelines for the management of traumatic pulmonary contusion: the role of non-invasive ventilatory support</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Vidhani, Kim ; Kause, Julianne ; Parr, Michael</creator><creatorcontrib>Vidhani, Kim ; Kause, Julianne ; Parr, Michael</creatorcontrib><description>Objective: To assess the management of patients with blunt traumatic pulmonary contusion admitted to our hospital. To identify the role of early blood gas analysis, non-invasive ventilation and to assess the validity of the current Advanced Trauma Life Support® manual statement that “Patients with significant hypoxia, i.e. PaO
2<65 mmHg or 8.6 kPa on room air, SaO
2<90%, should be intubated and ventilated within the first hour after injury”.
Setting: A 24 bed Intensive Care Unit in a major Trauma Centre situated in South Western Sydney, Australia.
Methods: Retrospective review of adults with blunt traumatic pulmonary contusion identified from the trauma registry.
Results: A total of 75 patients with an age range of 16–81 years were identified over a 2-year period. Arterial blood gas measurement was available for 32 patients during the immediate resuscitative period (<1 h from admission). All patients received supplemental oxygen and a PaO
2/FiO
2 ratio was calculated. Seven patients had significant pulmonary contusion, indicated by an initial PaO
2/FiO
2 ratio of <300, and were treated successfully with non-invasive ventilatory support. A further five patients without arterial blood gas (ABG) analysis on admission but with PaO
2/FiO
2 ratio of <300 in the ICU were also managed with non-invasive ventilatory support. Multi-modal analgesia was commonly used.
Conclusions: All major trauma patients admitted to our hospital received supplemental oxygen. Interpretation of ABG breathing room air was not used as an indicator for intubation. Most decisions to intubate early were based on clinical need. Patients with significant pulmonary contusion required intubation for reasons other than respiratory failure. Patients with significant pulmonary contusion were managed safely with non-invasive ventilatory support. Further investigation will determine the role of non-invasive ventilatory support in the management of these patients.</description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/S0300-9572(01)00475-0</identifier><identifier>PMID: 11886731</identifier><identifier>CODEN: RSUSBS</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analgesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Contusions - therapy ; Emergency and intensive respiratory care ; Female ; Humans ; Intensive care medicine ; Lung Injury ; Male ; Medical sciences ; Middle Aged ; Non-invasive ventilation ; Practice Guidelines as Topic ; Pulmonary contusion ; Respiration, Artificial ; Ventilatory support</subject><ispartof>Resuscitation, 2002-03, Vol.52 (3), p.265-268</ispartof><rights>2002 Elsevier Science Ireland Ltd</rights><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c391t-5524de4aa564dcc248e3d7d8690f84621b7c85cab73fcfab7007fc0fb857a8503</citedby><cites>FETCH-LOGICAL-c391t-5524de4aa564dcc248e3d7d8690f84621b7c85cab73fcfab7007fc0fb857a8503</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0300-9572(01)00475-0$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13546642$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11886731$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vidhani, Kim</creatorcontrib><creatorcontrib>Kause, Julianne</creatorcontrib><creatorcontrib>Parr, Michael</creatorcontrib><title>Should we follow ATLS® guidelines for the management of traumatic pulmonary contusion: the role of non-invasive ventilatory support</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>Objective: To assess the management of patients with blunt traumatic pulmonary contusion admitted to our hospital. To identify the role of early blood gas analysis, non-invasive ventilation and to assess the validity of the current Advanced Trauma Life Support® manual statement that “Patients with significant hypoxia, i.e. PaO
2<65 mmHg or 8.6 kPa on room air, SaO
2<90%, should be intubated and ventilated within the first hour after injury”.
Setting: A 24 bed Intensive Care Unit in a major Trauma Centre situated in South Western Sydney, Australia.
Methods: Retrospective review of adults with blunt traumatic pulmonary contusion identified from the trauma registry.
Results: A total of 75 patients with an age range of 16–81 years were identified over a 2-year period. Arterial blood gas measurement was available for 32 patients during the immediate resuscitative period (<1 h from admission). All patients received supplemental oxygen and a PaO
2/FiO
2 ratio was calculated. Seven patients had significant pulmonary contusion, indicated by an initial PaO
2/FiO
2 ratio of <300, and were treated successfully with non-invasive ventilatory support. A further five patients without arterial blood gas (ABG) analysis on admission but with PaO
2/FiO
2 ratio of <300 in the ICU were also managed with non-invasive ventilatory support. Multi-modal analgesia was commonly used.
Conclusions: All major trauma patients admitted to our hospital received supplemental oxygen. Interpretation of ABG breathing room air was not used as an indicator for intubation. Most decisions to intubate early were based on clinical need. Patients with significant pulmonary contusion required intubation for reasons other than respiratory failure. Patients with significant pulmonary contusion were managed safely with non-invasive ventilatory support. Further investigation will determine the role of non-invasive ventilatory support in the management of these patients.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analgesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Contusions - therapy</subject><subject>Emergency and intensive respiratory care</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Lung Injury</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Non-invasive ventilation</subject><subject>Practice Guidelines as Topic</subject><subject>Pulmonary contusion</subject><subject>Respiration, Artificial</subject><subject>Ventilatory support</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtu1DAUhi0EokPhEUDegGAROE7i2OkGVRU3aSQWU9aWxzlujRw72M5U7HkeHoInI3MRXbI6i_P95_IR8pzBWwase7eBBqDquahfA3sD0ApewQOyYlI0FeMCHpLVP-SMPMn5OwA0vBePyRljUnaiYSvya3MbZz_QO6Q2eh_v6OX1evPnN72Z3YDeBcxLI9Fyi3TUQd_giKHQaGlJeh51cYZOsx9j0OknNTGUObsYLg6BFD3u0RBD5cJOZ7dDulvyzusSFz7P0xRTeUoeWe0zPjvVc_Lt44frq8_V-uunL1eX68o0PSsV53U7YKs179rBmLqV2AxikF0PVrZdzbbCSG70VjTW2KUACGvAbiUXWnJozsmr49wpxR8z5qJGlw16rwPGOSvBeFf3nVxAfgRNijkntGpKblw-VAzUXr866Fd7twqYOuhX-wUvTgvm7YjDferkewFengCdjfY26WBcvuca3nZdWy_c-yOHi46dw6SycRgMDi6hKWqI7j-n_AV4cqUq</recordid><startdate>20020301</startdate><enddate>20020301</enddate><creator>Vidhani, Kim</creator><creator>Kause, Julianne</creator><creator>Parr, Michael</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20020301</creationdate><title>Should we follow ATLS® guidelines for the management of traumatic pulmonary contusion: the role of non-invasive ventilatory support</title><author>Vidhani, Kim ; Kause, Julianne ; Parr, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c391t-5524de4aa564dcc248e3d7d8690f84621b7c85cab73fcfab7007fc0fb857a8503</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analgesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Contusions - therapy</topic><topic>Emergency and intensive respiratory care</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Lung Injury</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Non-invasive ventilation</topic><topic>Practice Guidelines as Topic</topic><topic>Pulmonary contusion</topic><topic>Respiration, Artificial</topic><topic>Ventilatory support</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vidhani, Kim</creatorcontrib><creatorcontrib>Kause, Julianne</creatorcontrib><creatorcontrib>Parr, Michael</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vidhani, Kim</au><au>Kause, Julianne</au><au>Parr, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Should we follow ATLS® guidelines for the management of traumatic pulmonary contusion: the role of non-invasive ventilatory support</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2002-03-01</date><risdate>2002</risdate><volume>52</volume><issue>3</issue><spage>265</spage><epage>268</epage><pages>265-268</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><coden>RSUSBS</coden><abstract>Objective: To assess the management of patients with blunt traumatic pulmonary contusion admitted to our hospital. To identify the role of early blood gas analysis, non-invasive ventilation and to assess the validity of the current Advanced Trauma Life Support® manual statement that “Patients with significant hypoxia, i.e. PaO
2<65 mmHg or 8.6 kPa on room air, SaO
2<90%, should be intubated and ventilated within the first hour after injury”.
Setting: A 24 bed Intensive Care Unit in a major Trauma Centre situated in South Western Sydney, Australia.
Methods: Retrospective review of adults with blunt traumatic pulmonary contusion identified from the trauma registry.
Results: A total of 75 patients with an age range of 16–81 years were identified over a 2-year period. Arterial blood gas measurement was available for 32 patients during the immediate resuscitative period (<1 h from admission). All patients received supplemental oxygen and a PaO
2/FiO
2 ratio was calculated. Seven patients had significant pulmonary contusion, indicated by an initial PaO
2/FiO
2 ratio of <300, and were treated successfully with non-invasive ventilatory support. A further five patients without arterial blood gas (ABG) analysis on admission but with PaO
2/FiO
2 ratio of <300 in the ICU were also managed with non-invasive ventilatory support. Multi-modal analgesia was commonly used.
Conclusions: All major trauma patients admitted to our hospital received supplemental oxygen. Interpretation of ABG breathing room air was not used as an indicator for intubation. Most decisions to intubate early were based on clinical need. Patients with significant pulmonary contusion required intubation for reasons other than respiratory failure. Patients with significant pulmonary contusion were managed safely with non-invasive ventilatory support. Further investigation will determine the role of non-invasive ventilatory support in the management of these patients.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>11886731</pmid><doi>10.1016/S0300-9572(01)00475-0</doi><tpages>4</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Analgesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Contusions - therapy Emergency and intensive respiratory care Female Humans Intensive care medicine Lung Injury Male Medical sciences Middle Aged Non-invasive ventilation Practice Guidelines as Topic Pulmonary contusion Respiration, Artificial Ventilatory support |
| title | Should we follow ATLS® guidelines for the management of traumatic pulmonary contusion: the role of non-invasive ventilatory support |
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