Mechanical ventilation in trauma-the first 24 hours: A retrospective analysis
Journal Title: Indian Journal of Clinical Anaesthesia - Year 2018, Vol 5, Issue 4
Abstract
Introduction Warfare injuries are a special subset of trauma involving complex injury mechanisms and extensive tissue damage Theses mechanisms may lead to significant deterioration in lung function even in the absence of any signs of external thoracic injury due to primary or secondary insult on the lungs The mainstay in the management of these battlefield lung injuries is by initiating mechanical ventilation which either replaces or assists the functions of the respiratory systemMaterials and Methods A retrospective analysis was done from 1st January 2016 to 31st June 2016 of the data taken from the trauma register of our hospital Data was analysed and the need for mechanical ventilation was correlated with factors like injury severity score ISS injury profile and pulmonary and extrapulmonary using confidence interval and Odds ratio Paired differences were tested using Wilcoxon signed rank testResults Of the 528 warfare casualties received a total of 469 patients were enrolled and 942004 required mechanical ventilation in the immediate postoperative period and another 06 patients needed ventilation in the first 24 hours due to development of fat embolism syndrome All patients had an ISS of greater than 27489126 as compared to nonventilated patients odds 11 95 CI 085145 P042Conclusion Acute lung injury is a major cause of increased morbidity in patients with warfare injuries An aggressive and proactive approach of initiating mechanical ventilation can bring down complications and ICU stays Injury severity scoring can be used for predicting ALI in warfare casualties Lung protective ventilatory strategies can enhance patient recovery Keywords Mechanical ventilation Trauma Lung injury
Authors and Affiliations
Amit Sharma, Rakesh Kumar, U Naga Satish
Pediatric septic arthritis with pericardial and pleural effusions for emergency drainage - Case Report
Sepsis is a major cause of morbidity and mortality in pediatric age group, mainly because of hemodynamic compromise and multi-organ dysfunction. Septic patients have impaired tissue perfusion, threatening functions of vi...
A clinical comparative study of microcuff paediatric tracheal tube v/s uncuffed endotracheal tubes in paediatric airway management
Background: In paediatric airway management, uncuffed Endo tracheal tubes(UETT) were always thought to be safe for practice. Cuffed ETT(CETT) were found to cause airway edema and increased resistance to airflow in the po...
Comparison of three different concentrations of epidural ropivacaine (0.05%, 0.1% & 0.2%) for labor analgesia: A prospective randomized and double blind study
Introduction Epidural infusionof02ropivacaine is recommended by the manufacturer forlaboranalgesia but lower concentrations may be effective The present work is a clinical comparative study of different doses of ropivaca...
Comparison of hemodynamic and serum cortisol levels in response to anesthetic induction with Etomidate or Propofol in patients undergoing CABG surgery
Introduction: To compare the effects of induction agent etomidate and propofol on hemodynamic and serum cortisol levels in patients undergoing coronary artery bypass graft surgery on cardiopulmonary bypass. Materials and...
A comparative study of palonosetron and ondansetron in prevention of post operative nausea and vomiting in laparoscopic cholecystectomy surgery
Introduction: In this randomized, double-blind study we evaluated the relative efficacy of palonosetron (a new, selective 5hydroxytryptamine [5-HT3] receptor antagonist) and ondansetron in preventing postoperative nausea...