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Profile of Chest Injuries and Oxygen Therapy in Trauma Patients with Acute Respiratory Failure after the Jiangsu Tornado in China: A Retrospective Study

Published online by Cambridge University Press:  23 March 2020

Gen hua Mu Open the ORCID record for Gen hua Mu [Opens in a new window] ,
Zhong qian Lu ,
Xing Li ,
Ping fa Chen ,
Lei He ,
Yun hao Sun ,
Shan shan Hou  and
Yi jun Deng
Gen hua Mu*
Affiliation:
Emergency and Critical Care Center, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
Zhong qian Lu
Affiliation:
Emergency and Critical Care Center, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
Xing Li
Affiliation:
Emergency and Critical Care Center, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
Ping fa Chen
Affiliation:
Emergency and Critical Care Center, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
Lei He
Affiliation:
Emergency and Critical Care Center, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
Yun hao Sun
Affiliation:
Department of Thoracic and Cardiovascular Surgery, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
Shan shan Hou
Affiliation:
Pharmacy Department, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
Yi jun Deng*
Affiliation:
Emergency and Critical Care Center, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
*
Correspondence: Gen hua Mu, MD, Emergency and Critical Care Center, The Fourth Affiliated Hospital of Nantong University, No. 66 Renmin South Road, Yancheng224005, China, E-mail: mugenhua2009@163.com
Co-correspondence: Yi jun Deng, MD, PhD, E-mail: dengyj2003@163.com
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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.

Keywords

acute respiratory failurechest injuryoxygen therapyrib fracturestornadoes
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 3 , June 2020 , pp. 335 - 340
Copyright
© World Association for Disaster and Emergency Medicine 2020

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Footnotes

Note: Mu and Lu contributed equally to the work and should be considered co-first authors.

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