D. Akhmedov1, B.H. Davlatov1, A.P. Nurov2, H.A. Safoev2
INFLUENCE OF SEVERE BLUNT CHEST TRAUMA ON GAS EXCHANGE
1Department of Anesthesiology and Reanimatology, Avicenna Tajik State Medical University, Dushanbe, Tajikistan
2Department of Resuscitation, State Institution National Medical Center of Tajikistan, Dushanbe, Tajikistan
Objective: Study of the mechanisms of gas exchange abnormalities in a chest injury.
Methods: The state of gas exchange was studied in 40 patients with the blunt chest trauma (BCT) in the resuscitation unit of the National Medical Center of Tajikistan. In 10 (25%) patients were isolated, in 30 (75%) – combined injuries.
Results: The function of external respiration with the BCT was characterized with the reduction of respiratory volume and vital capacity of lungs, which was conducted with evident pain factor leading to the limitation of respiratory chest excursion.
Conclusions: The leading reasons for acute respiratory failures lay to severe arterial hypoxemia on the BCT are intrapulmonary trauma changes (lung contusion, multiple fractures of the rib), which cause to sharp enlargement of intrapulmonary shunting. In case of the chest injury without intrapulmonary damages, the main treatment measures should be aimed at eliminating the pain syndrome as the main pathogenetic mechanism of gas exchange disturbances. In the presence of intrapulmonary traumatic changes, the thorough sanitation of the tracheobronchial tree, the prevention of pneumonia and the transfer to artificial lung ventilation are of primary importance.
Keywords: Blunt chest trauma, closed chest injury, gas exchange, disturbance of external respiration functions, artificial lung ventilation
Ahmedov Jamoledin, Candidate of Medical Sciences, Associate Professor, Head of the Department of Anesthesiology and Reanimatology, Avicenna TSMU
Davlatov Bahriddin Khairiddinovich, Assistant of the Department of Anesthesiology and Reanimatology, Avicenna TSMU
Nurov Asat Pulodovich, Head of the Reanimation Department of National Medical Center
Safoev Khairiddin Amirkulovich, Doctor Anaesthetist-resuscitator, a Reanimation Department of National Medical Center
Address for correspondence
Davlatov Bahriddin Khairiddinovich
Assistant of the Department of Anesthesiology and Reanimatology, Avicenna TSMU
734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139
Tel.: (+992) 931 020286