Prehospital intubation of the moderately injured patient a cause of morbidity A matched-pairs analysis of 1,200 patients from the DGU Trauma Registry 英文参考文献.docVIP

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Prehospital intubation of the moderately injured patient a cause of morbidity A matched-pairs analysis of 1,200 patients from the DGU Trauma Registry 英文参考文献.doc

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Prehospital intubation of the moderately injured patient a cause of morbidity A matched-pairs analysis of 1,200 patients from the DGU Trauma Registry 英文参考文献

Hussmannetal.CriticalCare2011,15:R207 /content/15/5/R207 RESEARCH OpenAccess Prehospitalintubationofthemoderatelyinjured patient:acauseofmorbidity?Amatched-pairs analysisof1,200patientsfromtheDGUTrauma Registry BjoernHussmann1*,RolfLefering2,ChristianWaydhas1,SteffenRuchholtz3,AraschWafaisade2, MaxDanielKauther1andSvenLendemans1 Abstract Introduction:Hypoxiaandhypoxemiacanleadtoanunfavorableoutcomeafterseveretrauma,bybothdirect anddelayedmechanisms.Prehospitalintubationismeanttoensurepulmonarygasexchange.Limitedevidence existsregardingindicationsforintubationaftertrauma.Theaimofthisstudywastoanalyzeprehospitalintubation asanindependentriskfactorfortheposttraumaticcourseofmoderatelyinjuredpatients.Therefore,onlypatients who,inretrospect,wouldnothaverequiredintubationwereincludedinthematched-pairsanalysistoevaluate therisksrelatedtointubation. Methods:Thedataof42,248patientstakenfromthetraumaregistryoftheGermanAssociationforTrauma Surgery(DeutscheGesellschaftfürUnfallchirurgie(DGU))wereanalyzed.Patientswhometthefollowingcriteria wereincluded:primaryadmissiontoahospital;GlasgowComaScale(GCS)of13to15;age16yearsorolder; maximuminjuryseverityperbodyregion(AIS)≤3;noadministrationofpackedredbloodcellunitsinthe emergencytraumaroom;admissionbetween2005and2008;anddocumenteddataregardingintubation.The intubatedpatientswerethenmatchedwithnot-intubatedpatients. Results:Thestudypopulationincluded600matchedpairsthatmettheinclusioncriteria.Theresultsindicatedthat prehospitalintubationwasassociatedwithaprolongedrescuetime(notintubated,64.8minutes;intubated,82.3 minutes;P≤0.001)andahighervolumereplacement(notintubated,911.3ml;intubated,1,573.8ml;P≤0.001).In theintubatedpatients,coagulationparameters,suchastheprothrombintimeratio(PT)andplateletcount, declined,asdidthehemoglobinvalue(PTnotintubated:92.3%;intubated,85.7%;P≤0.001;hemoglobinnot intubated,13.4mg/dl;intubated,12.2mg/dl;P≤0.001).Intubationatthesceneresultedinanelevatedsepsisrate (notintubated,1.5%;intubated,3.7%;P≤0.02)anda