Purpose
Severe chest trauma remains a leading cause of trauma death after head injury (1).
The accurate assessment of thoracic trauma is difficult because of the variety of injuries associated with skeletal trauma and other complications risk factors.
The presence of a pulmonary contusion suggest major injury to the chest,
with primary etiological causes including falls and motor vehicle accidents (2).
In our specific population,
the impairment of pulmonary function is frequent and multifactorial (3).
The implication of chest trauma in mortality is related to the...
Methods and Materials
We revisioned 302 major trauma's patients (M 216,
F 86,
Mean Age 35+/- 10) that arrived in our Emergency Department from January 2012 to December 2012,
evaluating first exam and all following thoracic exams of all Intensive Care's patients; all MDCT studies were performed with same protocols and same CT unit (Ultra16Lightspeed,
GE).
In all patients were separately reported for each lung,
if present,
which kind of prevalent pattern (ground-glass,
reticular,
micronodular,
lobar consolidation,
disomogeneous consolidations),
if mechanically-ventilated patient,
if drainage pleuric was done,
if...
Results
In our study,
45/302 (15%) major trauma patients have depeloved infectious thoracic patterns,
clinically confirmed.
All 45 patients affected by lung infections were intubated and receiving mechanical ventilation during hospitalization.
18/45 (40%)Patients showed ground- glass pattern,
1/45 (2,2%) reticular pattern,
6/45 (13,3%) micronodular pattern,
8/45 (17,8%) lobar consolidation,
12/45 (26,7%) disomogenous consolidation.
The time median value of pattern appearance,
respect to time 0,
was of 3 days for ground glass pattern,
5 days for reticular pattern,
7days for the lobar consolidation and 9 days for...
Conclusion
Ground glass and micronodular may be considered early development pattern evolving towards lobar parenchymal consolidation or disomogeneous consolidation,
which together account for approximately 44% of pulmonary complications in patients with polytrauma.
The EOP develops in about 7 days after the event of major trauma,
but the "ground glass" and "centrolobular nodules" patterns can be considered the precursors of this important involvement.
On the basis of these results the pattern of early appearance can be considered as the new "risk factor" for the development of a...
References
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Janus T J,
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Predictors of Pneumonua in Trauma Patients with pulmonary contusion.
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Michelet P,
Couret D,
Brégeon F et al.
Early Onset Pneumonia in Severe Chest Trauma: a risk factor analysis.
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Ciesla DJ,
Moore EE,
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The role of the lung in postinjury multiple organ failure.
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Sauaia A,
Moore FA,
Moore...