Prevention and treatment of infectious complications of penetrating thoracic injuries

B N Kotiv; I M Samokhvalov; V Yu Markevich; A P Chuprina; I I Dzidzava; O V Barinov; V V Suvorov; A V Goncharov; A A Rud; K V Petukhov

doi:10.17816/brmma12240

Bulletin of the Russian Military Medical Academy ›› 2018, Vol. 20 ›› Issue (4) : 22 -25. DOI: 10.17816/brmma12240

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Prevention and treatment of infectious complications of penetrating thoracic injuries

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Abstract

Results of treatment of 325 wounded are analyzed with penetrating wounds of the chest and identify risk factors for the development of infectious complications. Found that infectious complications of the chest organs developed in 49 (15,1%) cases. It has been established that the most frequent infectious complications of penetrating wounds of the chest are post-traumatic pneumonia (67,3% of cases) and acute empyema of the pleura (26,5% of cases). The most prognostic significant risk factors for the development of infectious complications were identified: the type of injury (odds ratio - 2,48;95% confidence interval - 1,34-3,76), the severity of injuries (odds ratio - 7,88; 95% confidence interval - 3,9-15,92), blood loss (odds ratio - 3,09; 95% confidence interval - 1,6-5,94), duration of stay in the intensive care unit (odds ratio - 9,25;95% confidence interval - 4,57-18, 74), the intersection of chest wall structures (odds ratio - 2,84; 95% confidence interval- 1,24-6,47). Measures aimed at the prevention of infectious complications should be started from the moment the woundedperson enters the hospital. The priority tasks are to maintain the patency of the tracheobronchial tree, expanding the lung,adequate drainage and debridement of the pleural cavity. A high risk of developing infectious complications in penetratingwounds of the chest is expected in the wounded in a severe and extremely serious condition (according to the scale of fieldsurgery - condition at admission more than 31 points). The duration of stay in the intensive care unit for more than 4 daysincreases the probability of infectious complications 9 times.

Keywords

hemorrhage/surgery / hemopneumothorax / hemothorax / risk assessment / thoracic injuries / pneumonia / thoracotomy / trauma centers / wounds / penetrating / empyema and pleural

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B N Kotiv, I M Samokhvalov, V Yu Markevich, A P Chuprina, I I Dzidzava, O V Barinov, V V Suvorov, A V Goncharov, A A Rud, K V Petukhov. Prevention and treatment of infectious complications of penetrating thoracic injuries. Bulletin of the Russian Military Medical Academy, 2018, 20(4): 22-25 DOI:10.17816/brmma12240

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