Treatment of multiple rib fractures. Randomized controlled trial comparing ventilatory with nonventilatory management

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dc.contributor.authorBolliger C.T.
dc.contributor.authorVan Eeden S.F.
dc.date.accessioned2011-05-15T16:16:01Z
dc.date.available2011-05-15T16:16:01Z
dc.date.issued1990
dc.description.abstractWe studied the treatment of multiple rib fractures in NIC, comparing ventilatory with nonventilatory methods in 69 patients who were randomly allocated to one of the following two treatments: (1) a CPAP mask combined with regional analgesia (n = 36); or (2) endotracheal intubation and mechanical ventilation with PEEP (n = 33). Clinical outcome was as follows: mean duration of treatment, 4.5 ± 2.3 days for the group with CPAP and 7.3 ± 3.7 days for the intubated group (p = 0.0003); mean number of days spent in intensive care, 5.3 ± 2.9 days and 9.5 ± 4.4 days, respectively (p = < 0.0001); mean period of hospitalization, 8.4 ± 7.1 days and 14.6 ± 8.6 days, respectively (p = 0.0019); and patients developing complications: 28 percent (10/36) and 73 percent (24/33), respectively. Infections caused the difference in complications, primarily pneumonias, which occurred in 14 percent (5/36) of the group with CPAP but in 48 percent (16/33) of the intubated group. We conclude that treatment with a CPAP mask combined with regional analgesia can shorten and simplify treatment in these patients, mainly through a decreased infection rate, when compared with intubation and mechanical ventilation, and we recommend this treatment in patients similar to our sample.
dc.description.versionArticle
dc.identifier.citationChest
dc.identifier.citation97
dc.identifier.citation4
dc.identifier.issn00123692
dc.identifier.urihttp://hdl.handle.net/10019.1/13596
dc.subjectbupivacaine
dc.subjectmidazolam
dc.subjectmidazolam maleate
dc.subjectmorphine
dc.subjectadult
dc.subjectarticle
dc.subjectassisted ventilation
dc.subjectcomparative study
dc.subjectcomplication
dc.subjectendotracheal intubation
dc.subjectfemale
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectpneumonia
dc.subjectpositive end expiratory pressure
dc.subjectpriority journal
dc.subjectrib fracture
dc.subjectAnalgesia
dc.subjectComparative Study
dc.subjectFemale
dc.subjectHuman
dc.subjectIntubation, Intratracheal
dc.subjectLength of Stay
dc.subjectMale
dc.subjectMiddle Age
dc.subjectPneumonia
dc.subjectPositive-Pressure Respiration
dc.subjectRandomized Controlled Trials
dc.subjectRib Fractures
dc.titleTreatment of multiple rib fractures. Randomized controlled trial comparing ventilatory with nonventilatory management
dc.typeArticle
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