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

Journal of Critical Care

Volumn 29, Issue 1, 2014, Pages 139-143

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

^a BAYSTATE MEDICAL CENTER   (United States)

^b MEDICAL UNIVERSITY OF SOUTH CAROLINA   (United States)

^c UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

Author keywords

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

Indexed keywords

ADULT; ARTICLE; CLINICAL ARTICLE; CLINICAL EFFECTIVENESS; CLINICAL EVALUATION; CONTROLLED STUDY; DISEASE SEVERITY; FEMALE; FLAIL CHEST; FRACTURE FIXATION; HUMAN; INTENSIVE CARE; LENGTH OF STAY; MALE; MIDDLE AGED; RIB FIXATION; THORAX BLUNT TRAUMA; TREATMENT FAILURE; TREATMENT RESPONSE; VENTILATED PATIENT;

FLAIL CHEST; MECHANICAL VENTILATION; OUTCOME; RIB FRACTURE; SURGICAL RIB FIXATION; TRAUMA;

ADULT; AGE FACTORS; AGED; FEMALE; FLAIL CHEST; FRACTURE FIXATION, INTERNAL; HUMANS; INJURY SEVERITY SCORE; INTENSIVE CARE UNITS; LENGTH OF STAY; MALE; MIDDLE AGED; RESPIRATION, ARTIFICIAL; RIB FRACTURES; TIME FACTORS; TRAUMA CENTERS; WOUNDS, NONPENETRATING;

EID: 84890151596     PISSN: 08839441     EISSN: 15578615     Source Type: Journal    
DOI: 10.1016/j.jcrc.2013.08.003     Document Type: Article

References (19)

1. Bulger E.M., Arneson M.A., Mock C.N., et al. Rib fractures in the elderly. J Trauma 2000, 48:1040-1046. discussion 1046-1047.
2. Holcomb J.B., McMullin N.R., Kozar R.A., et al. Morbidity from rib fractures increases after age 45. J Am Coll Surg 2003, 196:549-555.
3. Pettiford B.L., Luketich J.D., Landreneau R.J. The management of flail chest. Thorac Surg Clin 2007, 17:25-33.
4. Todd S.R., McNally M.M., Holcomb J.B., et al. A multidisciplinary clinical pathway decreases rib fracture-associated infectious morbidity and mortality in high-risk trauma patients. Am J Surg 2006, 192:806-811.
5. Sirmali M., Turut H., Topcu S., et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg 2003, 24:133-138.
6. Bastos R., Calhoon J.H., Baisden C.E. Flail chest and pulmonary contusion. Semin Thorac Cardiovasc Surg 2008, 20:39-45.
7. Ciraulo D.L., Elliott D., Mitchell K.A., et al. Flail chest as a marker for significant injuries. J Am Coll Surg 1994, 178:466-470.
8. Nirula R., Mayberry J.C. Rib fracture fixation: controversies and technical challenges. Am Surg 2010, 76:793-802.
9. Ahmed Z., Mohyuddin Z. Management of flail chest injury: internal fixation versus endotracheal intubation and ventilation. J Thorac Cardiovasc Surg 1995, 110:1676-1680.
10. Solberg B.D., Moon C.N., Nissim A.A., et al. Treatment of chest wall implosion injuries without thoracotomy: technique and clinical outcomes. J Trauma 2009, 67:8-13. [discussion 13].
11. Voggenreiter G., Neudeck F., Aufmkolk M., et al. Operative chest wall stabilization in flail chest-outcomes of patients with or without pulmonary contusion. J Am Coll Surg 1998, 187:130-138.
12. Granetzny A., Abd El-Aal M., Emam E., et al. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg 2005, 4:583-587.
13. Tanaka H., Yukioka T., Yamaguti Y., et al. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma 2002, 52:727-732. [discussion 732].
14. Luchette F.A., Radafshar S.M., Kaiser R., et al. Prospective evaluation of epidural versus intrapleural catheters for analgesia in chest wall trauma. J Trauma 1994, 36:865-869. [discussion 869-870].
15. Flagel B.T., Luchette F.A., Reed R.L., et al. Half-a-dozen ribs: the breakpoint for mortality. Surgery 2005, 138:717-723. [discussion 723-715].
16. Mayberry J.C., Ham L.B., Schipper P.H., et al. Surveyed opinion of American trauma, orthopedic, and thoracic surgeons on rib and sternal fracture repair. J Trauma 2009, 66:875-879.
17. Lardinois D., Krueger T., Dusmet M., et al. Pulmonary function testing after operative stabilisation of the chest wall for flail chest. Eur J Cardiothorac Surg 2001, 20:496-501.
18. National Institute for Health and Clinical Excellence Guidance for the insertion of metal rib reinforcements to stabilise a flail chest wall Available at:, Accessed on November 8, 2010. http://guidanceniceorguk/IPG361.
19. Marasco S.F., Davies A.R., Cooper J., et al. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. J Am Coll Surg 2013, 216:924-932.