Siamak Rimaz; Vahideh Abdi; Cyrus Emir Alavi; Sanaz Masoumi; Mahsa Sadeghi; Mohammadreza Mobayen; Parissa Bagheri
Articles in Press, Accepted Manuscript, Available Online from 14 May 2025
Abstract
Objective: Burn injuries are a significant public health concern, contributing substantially to morbidity and mortality rates. Mechanical ventilation (MV) is crucial in managing critically ill patients with extensive burns. This study aimed to determine the survival rate of burn patients under mechanical ...
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Objective: Burn injuries are a significant public health concern, contributing substantially to morbidity and mortality rates. Mechanical ventilation (MV) is crucial in managing critically ill patients with extensive burns. This study aimed to determine the survival rate of burn patients under mechanical ventilation and identify the risk factors related to it. Methods: A cross-sectional analytical study was conducted at Velayat Hospital, affiliated with Guilan University of Medical Sciences, between March 21, 2011, and September 21, 2020. Data were retrieved from electronic hospital records and analyzed using SPSS version 28. Results: The mean age of survivors was 19.03±30.21 years, contrasting with 42.54±19.30 years in the deceased group. Among survivors, 30 were male (78.9%), while in the deceased group, 155 were male (64.9%). The average survival time in the intensive care unit was 18.33±1.36 days, with a median survival of 12±1.24 days. Significant differences were observed in age, length of stay, comorbidity, inhalation injury, sepsis, acute respiratory distress syndrome (ARDS), and acute kidney injury (AKI) between survivor and non-survivor groups (P<0.05). The Kaplan-Meier curve demonstrated a significant difference in survival probability between MV and non-MV groups (P=0.028), with higher survival probability observed in non-MV patients.Conclusion: Our findings indicate that factors such as age, length of stay, renal failure, ARDS, and sepsis are associated with increased mortality risk in mechanically ventilated burn patients. While these associations provide critical insights into potential risk factors, they should not be interpreted as causal relationships. Future research should explore these associations through interventional or longitudinal studies to establish causality and refine treatment strategies.
Ramin Tajvidi; Golnar Sabetian; hossein abdolrahimzadeh fard
Volume 12, Issue 3 , July 2024, , Pages 142-145
Abstract
Bronchial rupture following major blunt chest trauma should be suspected in any case of massive and persistentair leak through the intercostal drain tube. Chest radiographs and chest computed tomography scans (CT scans)are highly suggestive of this extremely rare tracheobronchial injury. The present ...
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Bronchial rupture following major blunt chest trauma should be suspected in any case of massive and persistentair leak through the intercostal drain tube. Chest radiographs and chest computed tomography scans (CT scans)are highly suggestive of this extremely rare tracheobronchial injury. The present study reported a patient whowas a 15-year-old boy. He was a case of a motor-car accident and was brought to the emergency room (ER)of Rajaie Hospital ( Shiraz, Iran) due to dyspnea and chest pain. The physical examination revealed a fewcrash injuries on his upper extremities, as well as subcutaneous emphysema in his neck. The chest X-rayrevealed a right clavicular fracture, multiple rib fractures, a right pneumothorax (but no complete collapseor fallen lung), and also pneumo-mediastinum and subcutaneous emphysema. The chest CT revealed severepulmonary contusion, severe right-sided pneumothorax, significant pneumo-mediastinum, subcutaneousemphysema, multiple right-side rib fractures, and mild displacement of the right main bronchus. Furthermore,no definitive signs of bronchial rupture were detected. Using a mechanical ventilator, the following parameterswere revealed. The maximum pressure (Pmax)=7cm, H2o (was very low), plateau pressure (P. Plateau), andexpiratory tidal volume (TV) were not detected due to insufficient amounts. Additionally, increasing TV didnot change those values. Bronchial rupture is one of the most important and serious differential diagnoses inforceful chest traumas when the mechanical ventilator reveals low Pmax, very low P.platue, and expiratory TV,with no change in those values with increasing TV.
Bijan Ziaeian; Sedigheh Tahmasebi; Hadi Niakan; Afsoun Fazelzadeh
Volume 1, Issue 3 , July 2013, , Pages 112-115
Abstract
Objectives: To compare the results of early versus late tracheostomy in trauma patients admitted to intensive care unit (ICU).Methods: This was case control study being performed at a major trauma centre in Shiraz, Iran including 120 trauma patients admitted to ICU during a 2-year period and underwent ...
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Objectives: To compare the results of early versus late tracheostomy in trauma patients admitted to intensive care unit (ICU).Methods: This was case control study being performed at a major trauma centre in Shiraz, Iran including 120 trauma patients admitted to ICU during a 2-year period and underwent tracheostomy during their ICU stay. The patients were categorized into two groups of the early tracheostomy who underwent tracheostomy within the first 7 days of initiation of mechanical ventilation (n=60), and the late tracheostomy group, in which tracheostomy was performed after 7 days (n=60). The duration of mechanical ventilation, ICU stay and hospital stay as well as mortality rates in ICU and hospital were recorded and compared between two study groups.Results: The baseline characteristics such as age (p=0.325), sex (p=0.071), Glasgow coma scale (GCS) (p=0.431) and the mechanism of injury (p=0.822) were comparable between two study groups. Early tracheostomy was associated with a significantly shorter duration of mechanical ventilation (p=0.008) and shorter ICU stay (p=0.003). Hospital stay (p=0.165), ICU mortality (p=0.243), and hospital mortality (p=0.311) were not different between the two study groups.Conclusion: Early tracheostomy is associated with reduced ICU stay and shorter duration of mechanical ventilation. Adopting a standardized strategy may improve resource utilization.
