| Low incidence of multiple organ failure after major trauma. | |
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MedLine Citation:
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PMID: 17572416 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In major trauma patients, multiple organ failure (MOF) is considered a leading cause of death. Acute lung injury is deemed a "pacemaker" of MOF. The purpose of this study was to determine if incidence of organ failure and mortality in multiple trauma patients can be reduced by implementation of lung-protective strategies. METHODS: All critically ill multiple trauma patients admitted to the ICU of a major trauma center in Berlin, Germany from January 1999 to December 2002 were analyzed retrospectively. Patients were ventilated pressure controlled with low tidal volumes and adequate PEEP. RESULTS: n=287 patients were included. The most frequent injuries were traumatic brain injury (TBI-68%), chest trauma (68%), and lung contusions (55%). Injury severity score (ISS) was 32+/-19 (mean+/-standard deviation), polytraumaschluessel (PTS) 34+/-19, and APACHE II 14+/-7. During their ICU-stay 16 patients died, 9 (56%) from TBI. Single-organ-failure occurred in n=69 patients (24%, mortality 5%), two-organ-failure in n=22 (8%, mortality 14%), and MOF in n=9 (3%, mortality 13%); one patient died from MOF 14 days after trauma. The number of days on mechanical ventilation increased depending on the number of organs failed (R=0.618, p<0.001). Seven patients (2%) fulfilled ARDS criteria for longer than 24h despite optimized ventilatory settings, one died of irreversible shock. Patients with MOF had a significantly increased ICU-LOS (35+/-15 days) compared to patients without organ failure (11+/-11 days; p<0.001). CONCLUSION: The low incidence of MOF in our series of trauma patients suggests that MOF may be prevented in some patients by implementation of lung-protective strategies. The improved outcome was associated with an increased ICU-LOS. |
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Authors:
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Sven Laudi; Bernd Donaubauer; Thilo Busch; Thoralf Kerner; Sven Bercker; Hermann Bail; Aarne Feldheiser; Norbert Haas; Udo Kaisers |
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Publication Detail:
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Type: Journal Article Date: 2007-06-18 |
Journal Detail:
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Title: Injury Volume: 38 ISSN: 0020-1383 ISO Abbreviation: Injury Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-08-24 Completed Date: 2008-03-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0226040 Medline TA: Injury Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1052-8 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology and Intensive Care Medicine, University of Leipzig Medical Faculty, 04103 Leipzig, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Female Humans Injury Severity Score Male Middle Aged Multiple Organ Failure / mortality*, prevention & control, therapy Multiple Trauma / mortality*, prevention & control, therapy Positive-Pressure Respiration / methods Respiration, Artificial / methods* Retrospective Studies Trauma Centers |
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