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Bulletin of Emergency and Trauma، جلد ۱۲، شماره ۳، صفحات ۱۴۲-۱۴۵
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عنوان انگلیسی The Great Role of Ventilator Parameters in Diagnosis of Right Main Bronchus Rupture Due to Blunt Chest Trauma
چکیده انگلیسی مقاله Bronchial rupture following major blunt chest trauma should be suspected in any case of massive and persistent
air leak through the intercostal drain tube. Chest radiographs and chest computed tomography scans (CT scans)
are highly suggestive of this extremely rare tracheobronchial injury. The present study reported a patient who
was a 15-year-old boy. He was a case of a motor-car accident and was brought to the emergency room (ER)
of Rajaie Hospital ( Shiraz, Iran) due to dyspnea and chest pain. The physical examination revealed a few
crash injuries on his upper extremities, as well as subcutaneous emphysema in his neck. The chest X-ray
revealed a right clavicular fracture, multiple rib fractures, a right pneumothorax (but no complete collapse
or fallen lung), and also pneumo-mediastinum and subcutaneous emphysema. The chest CT revealed severe
pulmonary contusion, severe right-sided pneumothorax, significant pneumo-mediastinum, subcutaneous
emphysema, multiple right-side rib fractures, and mild displacement of the right main bronchus. Furthermore,
no definitive signs of bronchial rupture were detected. Using a mechanical ventilator, the following parameters
were revealed. The maximum pressure (Pmax)=7cm, H2
o (was very low), plateau pressure (P. Plateau), and
expiratory tidal volume (TV) were not detected due to insufficient amounts. Additionally, increasing TV did
not change those values. Bronchial rupture is one of the most important and serious differential diagnoses in
forceful chest traumas when the mechanical ventilator reveals low Pmax, very low P.platue, and expiratory TV,
with no change in those values with increasing TV.
کلیدواژه‌های انگلیسی مقاله Tracheobronchial ruptures,motor-car accident,CT scan,Trauma,Mechanical ventilation
نویسندگان مقاله Ramin Tajvidi |
Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Golnar Sabetian |
Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Hossein Abdolrahimzadeh Fard |
Trauma Research Center. Shiraz. Iran.

نشانی اینترنتی https://beat.sums.ac.ir/article_50359_745e4ab9cd9aa52b6779ec76df277145.pdf
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