Document Detail


Thoracic gunshot wounds: alterations to pulmonary function and respiratory muscle strength.
MedLine Citation:
PMID:  20938263     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The impact on respiratory function of gunshot injuries to the chest is unknown. The objective is to assess pulmonary function and respiratory muscle strength (RMS) in patients who have recently sustained an isolated gunshot injury to the chest. METHODS: After institutional review board approval, patients with isolated gunshot injuries to the chest were prospectively identified. Study patients underwent pulmonary function testing and an assessment of RMS and gas exchange. RESULTS: Ten male patients sustaining an isolated pulmonary gunshot wound were prospectively enrolled with a mean age of 29 years ± 10 years and mean Injury Severity Score of 15 ± 5. All patients had an associated pneumothorax (n = 1), hemothorax (n = 4), or a combination of both (n = 5). After removal of all thoracostomy tubes and before discharge [7.4 days ± 5.4 days (range, 2-21 days)], patients underwent respiratory function testing. Lung volume subdivisions were reduced by 25% to 60% of predicted and diffusion capacity by 37% with preservation of the normal ratio of diffusion capacity to alveolar volume. In the six subjects able to perform spirometry in seated and supine postures, forced vital capacity decreased by 20% when changing posture (p = 0.046). Arterial blood gas analysis showed significant reduction in the P(AO)₂/FIO₂ ratio (or increase in AaDO₂). Maximal respiratory pressures were severely reduced from predicted values, the maximal inspiratory pressure by 60% and the maximal expiratory pressure by 78%. CONCLUSIONS: Lung volumes and RMS are decreased moderately to severely in patients who have sustained an isolated pulmonary gunshot wound. Expiratory muscle force generation is more severely affected than inspiratory muscle force. Further investigation of the long-term impact of these injuries on respiratory function is warranted.
Authors:
Ahmet Baydur; Kenji Inaba; Galinos Barmparas; Pedro Teixeira; Awrey Julianne; Marko Bukur; Peep Talving; Demetrios Demetriades
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  69     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-12     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  756-60     Citation Subset:  AIM; IM    
Affiliation:
Divisions of Pulmonary, Keck School of Medicine, University of Southern California Medical Center, Los Angeles, California, USA. baydrur@usc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Gas Analysis
Hemothorax / physiopathology*,  therapy
Humans
Lung Volume Measurements
Male
Middle Aged
Muscle Strength / physiology*
Pneumothorax / physiopathology*,  therapy
Prospective Studies
Respiratory Function Tests*
Respiratory Mechanics / physiology
Respiratory Muscles / physiopathology*
Thoracic Injuries / physiopathology*,  therapy
Wounds, Gunshot / physiopathology*,  therapy
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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