Cardiothoracic Surgery |

Evaluation of Respiratory Functions in Chest Trauma Patients Treated With Thoracic Wall Stabilization FREE TO VIEW

Mohamed Badawy, MD; Karam Moslam*, MD
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Qena Faculty of Medicine, Luxor, Egypt

Chest. 2012;142(4_MeetingAbstracts):73A. doi:10.1378/chest.1389417
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SESSION TYPE: Thoracic Surgery Posters II

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: To evaluate pulmonary function tests and blood gas analysis in patients with thoracic wall surgical stabilization for flail chest.

METHODS: 40 patients (30 men, 10 women; mean age 42.6 years) with antero-lateral flail chest (≧4 ribs fractured at ≧2 sites) were fulfilled the inclusion criteria and underwent surgical stabilization using metallic reconstruction plates. Clinical assessment, pulmonary function testing and blood gas were performed at 3 months following surgery. 10 patients couldn't able to perform pulmonary function because of either unstable or uncooperative.

RESULTS: Indications for surgical fixation were as follow: 10 patients required thoracotomy because of associated thoracic injuries; 15 non-intubated patients had antero-lateral flail chest; 15 patients without pulmonary contusion presented with impaired pulmonary function despite a few days (median 3 days) required (early surgical stabilization). There was no 30-day and 3 month mortality for the surgically treated patients. The median intensive care unit stay was 4.5 days. Infectious complications occurred in 5 % (2/40 patients). A satisfactory stabilization of the chest wall was obtained in all surgically treated patients. There were statistically significant difference in Pao2 (62.2± 8.3& 97.6±6.4), Paco2 (38.1±9.3& 32.4±8.4) and So2 (89.2%±1.4& 98.4±1.6) with P value <0.001 respectively. Improvement of pulmonary function test was significant in FVC (69.28±5.9& 78.55±5.5), FEV1 (68.07±4.7&78.97±3.9) FEV1/FVC ratio (98.25±9.3&100.53±6.9) and PEF (72.68±4.7& 80.23±4.1) with p value 0.001, 0.001, 0.08, 0.001 respectively.

CONCLUSIONS: surgical stabilization of flail chest with metallic plates is a safe and effective therapy in properly selected patients. These Patients had a significantly smoother course during the intensive care unit and hospital stays, had a significantly decreased rate of complications, and had almost no residual chest wall deformity.

CLINICAL IMPLICATIONS: Surgical stabilization may provide an early restoration of chest wall contour and result in a significant reduction in the duration of ventilatory support. Long-term postoperative pulmonary function seems to be better preserved after surgical stabilization.

DISCLOSURE: The following authors have nothing to disclose: Mohamed Badawy, Karam Moslam

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Qena Faculty of Medicine, Luxor, Egypt




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