Pulmonary Contusion Flail Chest Complex
Condition: Pulmonary Contusion
MeSH terms: Contusions; Flail Chest
Study type: Observational [Patient Registry]

Summary: 
      The study included 20 adult patients presented by multiple fractured ribs (flail segment)
      with thoracic trauma severity score (TTSS) between 5 and 15. All patients received
      mid-thoracic epidural analgesia with 0.125% Bupivacaine and 1 μg/ml fentanyl. The patients
      were ventilated using non-invasive positive pressure ventilation (NIPPV). Follow up arterial
      blood gases, chest X-ray and CT scan were obtained. Parameters to be recorded: Patient's
      characteristics and clinical data including pulmonary contusion, number of fractured ribs,
      pleural involvement, PaO2/FiO2 ratio on admission, weaning outcome, duration of NIPPV, length
      of stay in ICU (LOS ICU), complications and mortality rate.
    

Detailed description: 
      20 Patients fulfilling the inclusion criteria were submitted to strapping and packing in the
      form of dressing and fixing with elastoplast. All patients were ventilated using NIPPV
      (Engstrom Carestation), which was delivered to the patient through full-face mask and was
      started with pressure support of 8-12 cmH2O and PEEP of 3-5 cmH2O and gradually increased in
      2 cmH2O steps. When patients tolerate FiO2 ≤ 0.5 with pressure support ≤ 8 cmH2O and PEEP ≤ 5
      cmH2O for > 6 consecutive hours, withdrawal from NIPPV was attempted daily in 30 minutes
      spontaneous breathing trials. Therapy was considered successful if endotracheal intubation
      was avoided and the patient could be discharged from the ICU. During this period follow up
      arterial blood gases, chest X-rays and CT scans were obtained.
    

Intervention name(s): Noninvasive positive pressure ventilation
Intervention type(s): Other
Intervention description(s): All patients were ventilated using NIPPV (Engstrom Carestation), which was delivered to the patient through full-face mask and was started with pressure support of 8-12 cmH2O and PEEP of 3-5 cmH2O and gradually increased in 2 cmH2O steps. When patients tolerate FiO2 ≤ 0.5 with pressure support ≤ 8 cmH2O and PEEP ≤ 5 cmH2O for > 6 consecutive hours, withdrawal from NIPPV was attempted daily in 30 minutes spontaneous breathing trials.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        20 Patients fulfilling the inclusion criteria were submitted to strapping and packing in
        the form of dressing and fixing with elastoplast. All patients were ventilated using NIPPV
        (Engstrom Carestation), which was delivered to the patient through full-face mask and was
        started with pressure support of 8-12 cmH2O and PEEP of 3-5 cmH2O and gradually increased
        in 2 cmH2O steps. When patients tolerate FiO2 ≤ 0.5 with pressure support ≤ 8 cmH2O and
        PEEP ≤ 5 cmH2O for > 6 consecutive hours, withdrawal from NIPPV was attempted daily in 30
        minutes spontaneous breathing trials. Therapy was considered successful if endotracheal
        intubation was avoided and the patient could be discharged from the ICU. During this period
        follow up arterial blood gases, chest X-rays and CT scans were obtained.