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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

  • Gen hua Mu (a1), Zhong qian Lu (a1), Xing Li (a1), Ping fa Chen (a1), Lei He (a1), Yun hao Sun (a2), Shan shan Hou (a3) and Yi jun Deng (a1)...

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.

Copyright

Corresponding author

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

Footnotes

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

Footnotes

References

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1.Lyu, HM, Wang, GF, Cheng, WC, Shen, SL.Tornado hazards on June 23 in Jiangsu Province, China: preliminary investigation and analysis. Natural Hazards. 2017;85(1):597604.
2.LoCicero, J, Mattox, KL.Epidemiology of chest trauma. Surg Clin North Am. 1989;69(1):1519.
3.Veysi, VT, Nikolaou, VS, Paliobeis, C, Efstathopoulos, N, Giannoudis, PV.Prevalence of chest trauma, associated injuries and mortality: a level I trauma center experience. International Orthopaedics. 2009;33(5):14251433.
4.Gennarelli, TA, Wodzin, E. AIS 2005: a contemporary injury scale. Injury. 2006;37(12):10831091.
5.Deng, Q, Lv, Y, Xue, C, Kang, P, Dong, J, Zhang, L.Pattern and spectrum of tornado injury and its geographical information system distribution in Yancheng, China: a cross-sectional study. BMJ Open. 2018;8(6):e021552.
6.Jia, H, Pan, D.Tornado disaster impacts and management: learning from the 2016 tornado catastrophe in Jiangsu Province, China. Natural Hazards. 2017;89(1):457471.
7.Millie, M, Senkowski, C, Stuart, L, Davis, F, Ochsner, G, Boyd, C.Tornado disaster in rural Georgia: triage response, injury patterns, lessons learned. Am Surg. 2000;66(3):223228.
8.Brown, S, Archer, P, Kruger, E, Mallonee, S.Tornado-related deaths and injuries in Oklahoma due to the 3 May 1999 tornadoes. Weather Forecasting. 2002;17(3):343353.
9.Daley, WR, Brown, S, Archer, P, et al.Risk of tornado-related death and injury in Oklahoma, May 3, 1999. Am J Epidemiol. 2005;161(12):11441150.
10.Niederkrotenthaler, T, Parker, EM, Ovalle, F, et al.Injuries and post-traumatic stress following historic tornados: Alabama, April 2011. PLOS One. 2013;8(12):e83038.
11.Bulger, EM, Arneson, MA, Mock, CN, Jurkovich, GJ.Rib fractures in the elderly. J Trauma. 2000;48(6):10401046.
12.Battle, C, Hutchings, H, Evans, PA.Outcomes in older blunt chest wall trauma patients: a retrospective study. Critical Care. 2012;16(Suppl 1):453.
13.Holcomb, JB, McMullin, NR, Kozar, RA, Lygas, MH, Moore, FA.Morbidity from rib fractures increases after age 45. J Am Col Surg. 2003;196(4):549555.
14.Ng, S, Seethala, R, Yang, Y, et al.Risk factors for respiratory failure in elderly patients with traumatic rib fractures. Crit Care Med. 2012;40(12):5354.
15.Bergeron, E, Lavoie, A, Clas, D, et al.Elderly trauma patients with rib fractures are at greater risk of death and pneumonia. J Trauma. 2003;54(3):478485.
16.Sirmali, M.A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003;24(1):133138.
17.Karadayi, S, Nadir, A, Sahin, E, Celik, B, Arslan, S, Kaptanoglu, M.An analysis of 214 cases of rib fractures. Clinics. 2011;66(3):449451.
18.Novakov, I.The incidence of pulmonary contusion in blunt thoracic trauma: self-experience study. Chest. 2014;145(Suppl 3):47A.
19.Roberts, DJ, Leigh-Smith, S, Faris, PD, et al.Clinical presentation of patients with tension pneumothorax: a systematic review. Annals of Surgery. 2015;261(6):10681078.
20.Battle, CE, Evans, PA.Predictors of mortality in patients with flail chest: a systematic review. Emerg Med J. 2015;32(12):961965.
21.Amital, A, Shitrit, D, Fox, BD, et al.Long-term pulmonary function after recovery from pulmonary contusion due to blunt chest trauma. Israel Medical Association Journal. 2009;11(11):673676.
22.Richter, T, Ragaller, M.Ventilation in chest trauma. J Emerg Trauma Shock. 2011;4(2):251259.
23.Rico, FR, Cheng, JD, Gestring, ML, Piotrowski, ES.Mechanical ventilation strategies in massive chest trauma. Crit Care Clinics. 2007;23(2):299315.
24.Duggal, A, Perez, P, Golan, E, Tremblay, L, Sinuff, T.Safety and efficacy of noninvasive ventilation in patients with blunt chest trauma: a systematic review. Crit Care. 2013;17(4):R142.
25.Hernandez, G, Fernandez, R, Lopez-Reina, P, et al.Noninvasive ventilation reduces intubation in chest trauma-related hypoxemia: a randomized clinical trial. Chest. 2010;137(1):7480.
26.Carron, M, Freo, U, Zorzi, M, Ori, C.Predictors of failure of noninvasive ventilation in patients with severe community-acquired pneumonia. J Crit Care. 2010;25(3):540.
27.Nishimura, M.High-flow nasal cannula oxygen therapy in adults. J Intensive Care. 2015;3(1):15.
28.Papazian, L, Corley, A, Hess, D, et al.Use of high-flow nasal cannula oxygenation in ICU adults: a narrative review. Intensive Care Med. 2016;42(9):13361349.
29.Gaunt, KA, Spilman, SK, Halub, ME, Jackson, JA, Lamb, KD, Sahr, SM.High-flow nasal cannula in a mixed adult ICU. Respiratory Care. 2015;60(10):13831389.
30.Simon, M, Braune, S, Frings, D, Wiontzek, AK, Klose, H, Kluge, S.High-flow nasal cannula oxygen versus non-invasive ventilation in patients with acute hypoxaemic respiratory failure undergoing flexible bronchoscopy--a prospective randomized trial. Crit Care. 2014;18(6):712.

Keywords

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

  • Gen hua Mu (a1), Zhong qian Lu (a1), Xing Li (a1), Ping fa Chen (a1), Lei He (a1), Yun hao Sun (a2), Shan shan Hou (a3) and Yi jun Deng (a1)...

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