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Pulmonary disability after severe blunt chest trauma
D H Livingston1, J D Richardson
1Department of Surgery, University of Louisville School of Medicine, Kentucky.
The Journal of Trauma
|May 1, 1990
Summary
Severe chest injury recovery is rapid for most patients, with pulmonary function tests (PFTs) returning to near normal within months. Long-term respiratory disability is uncommon after chest trauma, supporting intensive care resource allocation.
Area of Science:
- Trauma Surgery
- Pulmonary Medicine
- Critical Care Medicine
Background:
- Severe chest injuries often lead to significant pulmonary dysfunction.
- Understanding recovery timelines and long-term outcomes is crucial for patient management.
Purpose of the Study:
- To assess the timing of recovery and degree of residual pulmonary dysfunction after severe chest injury.
- To determine long-term respiratory disability in survivors of severe chest trauma.
Main Methods:
- Prospective study of 28 severe chest injury survivors (Group I) with serial pulmonary function tests (PFTs).
- Retrospective assessment of 16 patients (Group II) with previous severe chest injury (1-11 years prior).
- Standard spirometric measurements used for all PFTs.
Main Results:
- Initial PFTs post-discharge were markedly abnormal (40-50% predicted).
- Significant improvement observed by 4 months, with function near normal (65-90% predicted) by final follow-up.
- Long-term follow-up showed continued improvement, with <5% experiencing lasting respiratory disability.
- Most pre-injury employed patients returned to work within 6 months.
Conclusions:
- Recovery from severe chest injury is typically rapid, with pulmonary function largely restored within months.
- Serious long-term respiratory disability is uncommon in survivors of severe chest trauma.
- These findings support the allocation of substantial resources to intensive care for severe chest injury patients.