Evaluation of respiratory functions in chest trauma patients treated with thoracic wall stabilization

AbstractBackgroundSurgical stabilization may provide an early restoration of chest wall contour and lead to decrease in the duration of ventilatory support. Long-term postoperative pulmonary function seems to be better preserved after surgical stabilization.ObjectiveTo evaluate pulmonary function tests and oxygenation in patients with thoracic wall surgical stabilization for flail chest.Materials and methodsForty patients (30 men, 10 women; mean age 42.6years) with antero-lateral flail chest (⩾4 ribs fractured at ⩾2 sites) fulfilled the inclusion criteria and underwent surgical stabilization using metallic reconstruction plates under general anesthesia using lung protective ventilation strategy. Clinical assessment, pulmonary function testing and blood gas analysis were performed before surgery, and after 3months following surgery. Ten patients could not perform pulmonary function because of either instability or non-cooperation.ResultsIndications for surgical fixation were as follows: ten patients required thoracotomy because of associated thoracic injuries; fifteen non-intubated patients had antero-lateral flail chest; fifteen patients without pulmonary contusion presenting with impaired respiratory functions required early surgical stabilization.A satisfactory stabilization of the chest wall was obtained in all surgically treated patients. There were statistically significant differences in PaO2 (62.2±8.3 and 97.6±6.4), PaCo2 (38.1±9.3 and 32.4±8.4) and SpO2 (89.2%±1.4 and 98.4±1.6) with a P value