Surgical rib fixation for flail chest deformity improves liberation from mechanical ventilation

Andrew R. Doben, Evert A. Eriksson, Chadrick E. Denlinger, Stuart M. Leon, Deborah J. Couillard, Samir M. Fakhry, Christian T Minshall

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Purpose: The goal of this study was to determine the impact of surgical rib fixation (SRF) in a treatment protocol for severe blunt chest trauma. Materials and methods: Patients with flail chest admitted between September 2009 and June 2010 to our level I trauma center who failed traditional management and underwent SRF were matched with an historical group. Outcome variables evaluated include age, injury severity score, intensive care unit length of stay (LOS), hospital LOS, ventilator days, total number of rib fractures, and total number of segmental rib fractures. Results: The 2 groups were similar in age, injury severity score, intensive care unit LOS, hospital LOS, total number of rib fractures, and total segmental rib fractures. The operative group demonstrated a significant reduction in total ventilator days as compared with the nonsurgical group (4.5 [0-30] vs 16.0 [4-40]; P = .040). Patients with SRF were permanently liberated from the ventilator within a median of 1.5 days (0-8 days). Conclusions: Surgical rib fixation resulted in a significant decrease in ventilator days and may represent a novel approach to decreasing morbidity in flail chest patients when used as a rescue therapy in patients with declining pulmonary status. Larger studies are required to further identify these benefits.

Original languageEnglish (US)
Pages (from-to)139-143
Number of pages5
JournalJournal of Critical Care
Volume29
Issue number1
DOIs
StatePublished - Feb 2014

Fingerprint

Flail Chest
Ribs
Artificial Respiration
Rib Fractures
Length of Stay
Mechanical Ventilators
Injury Severity Score
Intensive Care Units
Trauma Centers
Clinical Protocols
Thorax
Morbidity
Lung
Wounds and Injuries

Keywords

  • Flail chest
  • Mechanical ventilation
  • Outcome
  • Rib fracture
  • Surgical rib fixation
  • Trauma

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Doben, A. R., Eriksson, E. A., Denlinger, C. E., Leon, S. M., Couillard, D. J., Fakhry, S. M., & Minshall, C. T. (2014). Surgical rib fixation for flail chest deformity improves liberation from mechanical ventilation. Journal of Critical Care, 29(1), 139-143. https://doi.org/10.1016/j.jcrc.2013.08.003

Surgical rib fixation for flail chest deformity improves liberation from mechanical ventilation. / Doben, Andrew R.; Eriksson, Evert A.; Denlinger, Chadrick E.; Leon, Stuart M.; Couillard, Deborah J.; Fakhry, Samir M.; Minshall, Christian T.

In: Journal of Critical Care, Vol. 29, No. 1, 02.2014, p. 139-143.

Research output: Contribution to journalArticle

Doben, AR, Eriksson, EA, Denlinger, CE, Leon, SM, Couillard, DJ, Fakhry, SM & Minshall, CT 2014, 'Surgical rib fixation for flail chest deformity improves liberation from mechanical ventilation', Journal of Critical Care, vol. 29, no. 1, pp. 139-143. https://doi.org/10.1016/j.jcrc.2013.08.003
Doben, Andrew R. ; Eriksson, Evert A. ; Denlinger, Chadrick E. ; Leon, Stuart M. ; Couillard, Deborah J. ; Fakhry, Samir M. ; Minshall, Christian T. / Surgical rib fixation for flail chest deformity improves liberation from mechanical ventilation. In: Journal of Critical Care. 2014 ; Vol. 29, No. 1. pp. 139-143.
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