The role of diagnosis of respiratory dysfunction in patients with thoracic trauma with polytrauma

  • O. V. Boiko
  • Yu.V. Volkova
Keywords: thoracic injury, polytrauma, respiratory function, respiratory dysfunction, spirography.


Annotation. Combined thoracic trauma is one of the most unfavorable in determining the prognosis in patients with polytrauma. The aim of the study was to evaluate the informativeness of the spirography method in patients with concomitant thoracic trauma as a prognostic criterion for the severity of the course of traumatic disease and the effect of the proposed modifications of the intensive care algorithm on treatment results. A study of the state of indicators of the function of external respiration was carried out using the method of spirography in 92 patients with concomitant thoracic trauma. The patients were divided into 3 groups depending on the foreseen leading pathogenetic mechanism of respiratory failure in all periods of traumatic illness. The effect of additional administration of ceruloplasmin solution, solution of D-fructose-1,6-diphosphate sodium salt hydrate solution was compared with the classical algorithm of intensive therapy. The effect of the proposed treatment was assessed 30 days after receiving polytrauma and the parameters of the external respiration function were compared with the data obtained in conditionally healthy volunteers. It was determined that the addition of a solution of ceruloplasmin to the algorithm of intensive therapy, the leading mechanism of action of which is the effect on oxidative stress, is the most pathogenetically determined in patients with concomitant thoracic trauma in polytrauma, which is confirmed by the most restored indicators of the function of external respiration in them, determined using spirography on the 30th day of observation. The data obtained are important in determining the prognosis of the course of traumatic illness and planning a rehabilitation program in patients with concomitant thoracic trauma.


1. Bienvenu, O. J., & Gerstenblith, T. A. (2017). Posttraumatic Stress Disorder Phenomena аfter Critical Illness. Crit Care Clin., 33 (3), 649–58. doi: 10.1016/j.ccc.2017.03.006

2. Ehrnthaller, C., Flierl, M., Perl, M., Denk, S., Unnewehr, H., Ward, P. A., … & Huber-Lang, M. (2015). The molecular fingerprint of lung inflammation after blunt chest trauma. Eur. J. Med. Res., 20 (1), 70. doi: 10.1186/s40001-015-0164-y

3. Khatiban, M., Shirani, F., Oshvandi, K., Soltanian, A. R., & Ebrahimian, R. (2018). Orem's Self-Care Model With Trauma Patients: A Quasi-Experimental Study. Nurs Sci Q, 31 (3), 272–8. doi: 10.1177/0894318418774876

4. Lv, X., Wen, T., Song, J., Xie, D., Wu, L., Jiang, X., ... & Wen, Z. (2017). Extracellular histones are clinically relevant mediators in the pathogenesis of acute respiratory distress syndrome. Respiratory Research., 18, 165.

5. Schulz-Drost, S., Ekkernkamp, A., & Stengel, D. (2018). Epidemiology, injury entities and treatment practice for chest wall injuries: Current scientific knowledge and treatment recommendations. Unfallchirurg, 121 (8), 605–14. doi: 10.1007/s00113-018-0532-5

6. Soto, G. J., Kor, D. J., Park, P. K., Hou, P. C., Kaufman, D. A., Kim, M., … & Ng Gong, M. (2016). Lung Injury Prediction Score in Hospitalized Patients at risk of Acute Respiratory Distress Syndrome. Crit. Care Med., 44 (12), 2182–91. doi: 10.1097/CCM.0000000000002001

7. Viola, H., Chang, J., Grunwell, J. R., Hecker, L., Tirouvanziam, R., Grotberg, J. B., & Takayama, S. (2019). Microphysiological systems modeling acute respiratory distress syndrome that capture mechanical force-induced injury-inflammation-repair. APL Bioeng., 3 (4), 041503. doi: 10.1063/1.5111549

8. Yamakawa, H., Hagiwara, E., Kitamura, H., Yamanaka, Y., Ikeda, S., Sekine, A., … & Ogura, T. (2017). Serum KL-6 and surfactant protein-D as monitoring and predictive markers of interstitial lung disease in patients with systemic sclerosis and mixed connective tissue disease. J. Thorac. Dis., 9 (2), 362–71. doi: 10.21037/jtd.2017.02.48
How to Cite
Boiko, O. V., & Volkova, Y. (2020). The role of diagnosis of respiratory dysfunction in patients with thoracic trauma with polytrauma. Reports of Vinnytsia National Medical University, 24(4), 665-669.