Thesis etd-05082024-105221 |
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Thesis type
Tesi di specializzazione (5 anni)
Author
NICCOLINI, EMMA
URN
etd-05082024-105221
Thesis title
Trauma toracico chiuso: studio TRACTIONS
(ThoRAciC Trauma IntubatiON risk Score for blunt trauma)
Department
MEDICINA CLINICA E SPERIMENTALE
Course of study
MEDICINA D'EMERGENZA URGENZA
Supervisors
relatore Prof. Ghiadoni, Lorenzo
Keywords
- thoracic trauma
- trauma toracico
Graduation session start date
04/06/2024
Availability
Full
Summary
Indubbia è la rilevanza mondiale del politrauma e la prevalenza in esso del trauma toracico contusivo, così come il riferimento nel protocollo ATLS della American College of Surgeons. Questa tesi sperimentale ed il relativo studio clinico multicentrico prospettico “TRACTIONS ThoRAciC Trauma IntubatiON risk Score for blunt trauma” hanno posto l’attenzione su alcune tematiche ancora aperte, ovvero: la possibilità di identificare uno score precoce per il rischio d’intubazione orotracheale, il potere predittivo dell’ecografia toracica (tramite lo score LUS) per il rischio d’intubazione e di sviluppo di ARDS, e quale possa essere la migliore modalità analgesica per questi pazienti. Considerando che la nostra tesi fa riferimento ad un’analisi ad interim di Settembre 2023, e che lo studio è ancora in corso, i risultati ottenuti fanno ben sperare nella possibilità di elaborare un score per il rischio d’intubazione, in particolare in riferimento al valore predittivo di fratture costali, frequenza respiratoria e LUS score polmonare.
The global relevance of polytrauma and the prevalence of blunt thoracic trauma in it are undoubted, as is the value of reference of the ATLS protocol elaborated by the American College of Surgeons. This experimental thesis and the related prospective multicenter clinical trial “TRACTIONS Trauma IntubatiON risk Score for blunt trauma” have focused on some issues still open, namely: the possibility of identifying an early score for the risk of orotracheal intubation, the predictive power thoracic ultrasound by the LUS score in spite of the risk of intubation and progression to ARDS, and which could be the best analgesic modality available for these patients.
Considering that our thesis refers to an interim analysis of 2023 September, while the trial in still ongoing, the initial results give us hope for the possibility of developing a score for intubation, in particular in reference to the predictive value of rib fractures, respiratory rate and LUS score.
The global relevance of polytrauma and the prevalence of blunt thoracic trauma in it are undoubted, as is the value of reference of the ATLS protocol elaborated by the American College of Surgeons. This experimental thesis and the related prospective multicenter clinical trial “TRACTIONS Trauma IntubatiON risk Score for blunt trauma” have focused on some issues still open, namely: the possibility of identifying an early score for the risk of orotracheal intubation, the predictive power thoracic ultrasound by the LUS score in spite of the risk of intubation and progression to ARDS, and which could be the best analgesic modality available for these patients.
Considering that our thesis refers to an interim analysis of 2023 September, while the trial in still ongoing, the initial results give us hope for the possibility of developing a score for intubation, in particular in reference to the predictive value of rib fractures, respiratory rate and LUS score.
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