Study Supports Broader Use of Rib Fixation in Flail Chest
FROM THE ANNUAL MEETING OF THE EASTERN ASSOCIATION FOR THE SURGERY OF TRAUMA
Finally, audience members asked why ICU times were not lower in the surgical group and how the authors addressed pulmonary contusions, since previous reports suggest either no benefit or worsened morbidity in patients with a significant underlying pulmonary contusion who undergo fixation for flail chest.
Dr. Doben said length of stay was likely not lower because they delayed surgery in a number of patients until their chest became their primary medical issue. He called for studies to address the issue of flail chest and contusions, but said that he and his colleagues have performed fixation in these patients reasonably early on, at 2 or 3 days into the course of their contusion, when their PaO2/FiO2 (P/F) ratio was markedly improved.
"Really, what kept them on the vent was more their mechanics and not their P/F ratios, and I think that’s a pretty definable time period," he said.
Dr. Doben and his coauthors reported having no conflicts of interest. Dr. Mayberry has grant/research support from, serves as a consultant to, and is on the speakers bureau for, Acute Innovations, a maker of thoracic surgery devices.
