Incidence and significance of respiratory failure after trauma in children was the subject of this study. One thousand nine hundred eighty-nine pediatric trauma patients (aged 18 years or less) were treated at the authors' level I trauma center between 1985 and 1993. Of these, 364 (18%) were intubated. Their mechanisms of injury were: motor vehicle accidents in 93 (25%), pedestrians struck by vehicles in 93 (25%), motorcycle or bicycle accidents in 55 (15%), gunshot and stab wounds in 43 (12%), major burns (> 20% BSA) in 31 (9%), 14 of whom also had smoke inhalation, falls in 25 (7%), sport-related injuries in 9 (2%), and child abuse in 8 (2%). Average injury severity score of intubated patients was 27.0 +/- 21.4. Average trauma score was 11.7 +/- 4.1. Of the intubated patients, 248 (68%) had head injuries, 153 (42%) chest injuries, and 114 (31%) abdominal and pelvic injuries. Ninety-three (25%) of intubated patients died within 5 days of injury: 70 of head injury, 23 of multiple major organ injury. Intubation was required for more than 5 days in 77 patients (21%); 50 (14%) of these patients met criteria for respiratory distress syndrome (RDS): 12 (24% of RDS patients) died. Two of the deaths were multiply traumatized patients, and 10 were patients with burns and smoke inhalation. The authors conclude that RDS is uncommonly the cause of death in pediatric trauma patients. Burned patients with RDS are an exceptional group, with significant mortality.
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http://dx.doi.org/10.1016/0022-3468(95)90143-4 | DOI Listing |
Crit Care Sci
January 2025
Anaesthesiology and Critical Care, All India Institute of Medical Sciences - Jodhpur, India.
Objective: Although the efficacy of high-flow nasal oxygen therapy in delaying or avoiding intubation in patients with hypoxemic respiratory failure has been studied, its potential for facilitating early weaning from invasive mechanical ventilation remains unexplored.
Methods: In this randomized controlled trial, 80 adults with acute hypoxemic respiratory failure requiring invasive mechanical ventilation for > 48 hours were enrolled and divided into two groups: conventional weaning and early weaning via high-flow nasal oxygen. In the conventional weaning group, the spontaneous breathing trial was performed after the PaO2/FiO2 ratio was ≥ 200, whereas in the high-flow nasal oxygen group, the spontaneous breathing trial was conducted earlier when the PaO2/FiO2 ratio was 150 - 200.
Arq Bras Oftalmol
January 2025
Department of Ophthalmology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Purpose: Congenital epiphora can be related to anomalies of the nasolacrimal duct. This study aimed to assess the distal end of the nasolacrimal duct and the outcomes of endoscopic treatment in children older than 12 months with congenital epiphora.
Methods: This retrospective analysis describes the clinical characteristics, management, and outcomes of symptomatic congenital lacrimal obstruction in 32 lacrimal systems of 23 children.
Laeknabladid
February 2025
Emergency Department, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
A case is reported of a man in his 70s that presented to the emergency department due to difficulty swallowing after a fall. He was found to have a large retropharyngeal hematoma, which led to complete airway obstruction about an hour after the injury. As oral endotracheal intubation was impossible due to the bleeding, an emergency cricothyrotomy was performed in an ambulance by an emergency medicine trainee.
View Article and Find Full Text PDFCan J Anaesth
January 2025
Department of Anesthesiology, Pain Management, and Perioperative Medicine, Dalhousie University, Halifax, NS, Canada.
PLoS One
January 2025
Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
Background: The relationships between pectoralis muscle parameters and outcomes in patients with coronavirus disease 2019 (COVID-19) remain uncertain.
Methods: We systematically searched PubMed, Embase, Web of Science and the Cochrane Library from 1 January 2019 to 1 May 2024 to identify non-overlapping studies evaluating pectoralis muscle-associated index on chest CT scan with clinical outcome in COVID-19 patients. Random-effects and fixed-effects meta-analyses were performed, and heterogeneity between studies was quantified using the I2 statistic.
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