Chest Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via ISI Web of Science (5)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Leone, M.
Right arrow Articles by Martin, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Leone, M.
Right arrow Articles by Martin, C.
(Chest. 2003;124:2261-2266.)
© 2003 American College of Chest Physicians

Pulmonary Contusion in Severe Head Trauma Patients*

Impact on Gas Exchange and Outcome

Marc Leone, MD; Jacques Albanèse, MD; Sébastien Rousseau, MD; François Antonini, MD; Myriam Dubuc, MD; Bernard Alliez, MD and Claude Martin, MD, FCCP

* From the Intensive Care Unit and Trauma Center (Drs. Leone, Albanèse, Rousseau, Antonini, and Martin), and the Departments of Biostatistics (Dr. Dubuc) and Neurosurgery (Dr. Alliez), Nord Hospital, AP-HM, Marseilles University Hospital System, Marseilles School of Medicine, Marseilles, France.

Correspondence to: Marc Leone, MD, Département d’Anesthésie et de Réanimation, Hôpital Nord, 13915 Marseille cedex, 20 France; e-mail : marc.leone{at}ap-hm.fr

Study objective: To evaluate the impact on morbidity and mortality of pulmonary contusion in multiple-trauma patients with severe head trauma.

Design: Matched-paired, case-control study

Setting: ICU at a tertiary university hospital.

Patients: During a 3-year period, 313 consecutive multiple-trauma patients with severe head trauma (Glasgow coma scale [GCS], <= 8) who were admitted to the ICU.

Interventions: Case-control matching criteria were as follows: (1) age difference within 5 years; (2) sex; (3) GCS in two categories; (4) similar pattern of injury; and (5) simplified acute physiology score II in five categories. A pulmonary contusion, defined by the clinical context and the result of a chest CT scan, was diagnosed in 90 patients. Analysis was performed on 90 pairs who were matched with 100% success.

Results: Ninety patients (29%) presented a diagnosis of pulmonary contusion. The presence of pulmonary contusion had an impact on the PaO2/fraction of inspired oxygen (FIO2) ratio, which was significantly reduced in patients with a pulmonary contusion. The ICU stay, the occurrence of complications such as nosocomial pneumonia or ARDS, the Glasgow outcome scale, and the mortality rate did not significantly differ between case patients and control subjects. Mortality also was not affected when patients were stratified according to the severity of the PaO2/FIO2 ratio.

Conclusion: In the study patients, pulmonary contusion alters gas exchange but does not appear to increase the morbidity and mortality of multiple-trauma patients with head trauma. A sample-size effect may limit the interpretation of the study.

Key Words: head trauma • ICU • pulmonary contusion






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2003 by the American College of Chest Physicians.