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Related Concept Videos

Flail Chest-I01:24

Flail Chest-I

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Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
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Flail Chest-II01:26

Flail Chest-II

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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
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Chest Physiotherapy01:24

Chest Physiotherapy

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Chest Physiotherapy (CPT) is a therapeutic technique used in respiratory care to improve ventilation, clear bronchial secretions, and enhance the efficiency of respiratory muscles. This therapy includes three primary procedures: postural drainage, percussion, and vibration. It can be performed on spontaneously breathing patients and those who are intubated and mechanically ventilated.
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Cancers Originate from Somatic Mutations in a Single Cell

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Cancer arises from mutations in the critical genes that allow healthy cells to escape cell cycle regulation and acquire the ability to proliferate indefinitely. Though originating from a single mutation event in one of the originator cells, cancer progresses when the mutant cell lines continue to gain more and more mutations, and finally, become malignant. For example, chronic myelogenous leukemia (CML) develops initially as a non-lethal increase in white blood cells, which progressively...
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The Soil Ecosystem02:23

The Soil Ecosystem

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Plants obtain inorganic minerals and water from the soil, which acts as a natural medium for land plants. The composition and quality of soil depend not only on the chemical constituents but also on the presence of living organisms. In general, soils contain three major components:
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The process of breathing, inhaling and exhaling, involves the coordinated movement of the chest wall, the lungs, and the muscles that move them. Two muscle groups with important roles in breathing are the diaphragm, located directly below the lungs, and the intercostal muscles, which lie between the ribs. When the diaphragm contracts, it moves downward, increasing the volume of the thoracic cavity and creating more room for the lungs to expand. When the intercostal muscles contract, the ribs...
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Quantification of Proliferative and Dead Cells in Enteroids
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Flail Chest: Less Deadly than Originally Thought.

Elizabeth Benjamin1,2, Gustavo Recinos3, Alberto Aiolfi3

  • 1Division of Trauma and Critical Care, University of Southern California, Los Angeles, CA, USA. Elizabeth.Benjamin@med.usc.edu.

World Journal of Surgery
|June 21, 2018
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Summary
This summary is machine-generated.

Mortality for isolated flail chest is lower than previously thought, with less than 30% requiring mechanical ventilation. However, mechanical ventilation is linked to increased mortality and pneumonia risk, especially in older patients.

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Area of Science:

  • Trauma surgery
  • Thoracic surgery
  • Critical care medicine

Background:

  • Flail chest is a severe injury with high mortality (10-20%) often complicated by other injuries.
  • The prognosis and physiological impact of isolated flail chest are not well understood.

Purpose of the Study:

  • To define the outcomes of isolated flail chest injuries.
  • To identify risk factors for mortality and mechanical ventilation.

Main Methods:

  • National Trauma Databank study (2007-2014).
  • Included patients with flail chest, excluding severe head/abdominal injuries, DOA, or transfers.
  • Primary outcome: mortality; Secondary outcomes: mechanical ventilation, pneumonia.

Main Results:

  • Isolated flail chest occurred in 1.4% of blunt chest trauma patients (8098 met criteria).
  • Mortality was 5.6%. 29.8% required mechanical ventilation; 11.2% developed pneumonia.
  • Age >65 and mechanical ventilation independently predicted mortality. Pulmonary contusion, cardiac contusion, and sternal fractures predicted ventilation need.

Conclusions:

  • Isolated flail chest mortality is lower than previously reported.
  • Mechanical ventilation is independently associated with mortality and pneumonia.
  • Age >65 is a risk factor for adverse outcomes; these patients may need aggressive management.