1. Profile of Chest Injuries and Oxygen Therapy in Trauma Patients with Acute Respiratory Failure after the Jiangsu Tornado in China: A Retrospective Study
- Author
-
Lei He, Yi Jun Deng, Ping fa Chen, Zhong Qian Lu, Gen Hua Mu, Xing Li, Yun Hao Sun, and Shan Shan Hou
- Subjects
Adult ,Male ,China ,Emergency Medical Services ,Thoracic Injuries ,Chest injury ,Emergency Nursing ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Injury Severity Score ,law ,Fraction of inspired oxygen ,medicine ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,Respiratory Distress Syndrome ,Abbreviated Injury Scale ,business.industry ,Multiple Trauma ,Oxygen Inhalation Therapy ,030208 emergency & critical care medicine ,Emergency department ,Middle Aged ,medicine.disease ,Polytrauma ,Intensive care unit ,Pulmonary contusion ,Tornadoes ,030228 respiratory system ,Respiratory failure ,Anesthesia ,Child, Preschool ,Emergency Medicine ,Female ,business - Abstract
Background:The aim of this study was to analyze the profile of chest injuries, oxygen therapy for respiratory failure, and the outcomes of victims after the Jiangsu tornado, which occurred on June 23, 2016 in Yancheng City, Jiangsu Province, China.Methods:The clinical records of 144 patients referred to Yancheng City No.1 People’s Hospital from June 23 through June 25 were retrospectively investigated. Of those patients, 68 (47.2%) sustained major chest injuries. The demographic details, trauma history, details of injuries and Abbreviated Injury Scores (AIS), therapy for respiratory failure, surgical procedures, length of intensive care unit (ICU) and hospital stay, and mortality were analyzed.Results:Of the 68 patients, 41 (60.3%) were female and 27 (39.7%) were male. The average age of the injured patients was 57.1 years. Forty-six patients (67.6%) suffered from polytrauma. The mean thoracic AIS of the victims was calculated as 2.85 (SD = 0.76). Rib fracture was the most common chest injury, noted in 56 patients (82.4%). Pulmonary contusion was the next most frequent injury, occurring in 12 patients (17.7%). Ten patients with severe chest trauma were admitted to ICU. The median ICU stay was 11.7 (SD = 8.5) days. Five patients required intubation and ventilation, one patient was treated with noninvasive positive pressure ventilation (NPPV), and four patients were treated with high-flow nasal cannula (HFNC). Three patients died during hospitalization. The hospital mortality was 4.41%.Conclusions:Chest trauma was a common type of injury after tornado. The most frequent thoracic injuries were rib fractures and pulmonary contusion. Severe chest trauma is usually associated with a high incidence of respiratory support requirements and a long length of stay in the ICU. Early initiation of appropriate oxygen therapy was vital to restoring normal respiratory function and saving lives. Going forward, HFNC might be an effective and well-tolerated therapeutic addition to the management of acute respiratory failure in chest trauma.
- Published
- 2020