n Southern African Journal of Critical Care - The effect of penetrating trunk trauma and mechanical ventilation on the recovery of adult survivors after hospital discharge
|Article Title||The effect of penetrating trunk trauma and mechanical ventilation on the recovery of adult survivors after hospital discharge|
|© Publisher:||Health and Medical Publishing Group (HMPG)|
|Journal||Southern African Journal of Critical Care|
|Author||H. Van Aswegen, C. Eales, G.A. Richards, J. Goosen and P. Becker|
|Publication Date||Jul 2010|
|Pages||25 - 32|
|Keyword(s)||Charlotte Maxeke Johannesburg Academic Hospital, Medical Research Council and University of the Witwatersrand|
Objectives. To establish whether survivors of penetrating trunk trauma recover adequately and spontaneously following critical illness.
Material and methods. A prospective observational study was conducted. Intubated and ventilated males and females with penetrating trunk trauma (SV group (mechanical ventilation (MV) <5 days, N=13), LV group (MV ≥5 days, N=29)) were recruited from four intensive care units. Dynamometry, lung function tests, 6-minute walk distance (6MWD), oxygen uptake and quality of life (QOL), assessed with the short form-36 English UK version (SF-36) questionnaire, were recorded over a 6-month period following discharge. Results were compared with a healthy control group (N=40).
Results. In the LV group, 6MWD was reduced in comparison wit h controls at 1 (p=0.00) and 3 months (p=0.00) after discharge. Morbidity correlated with 6MWD at 3 (p=0.03) and 6 months (p=0.02), and there was a reduction in strength at 1, 3 and 6 months relative to the SV group and controls (p=0.00 - 0.04). In addition, intensive care unit and hospital length of stay correlated with muscle strength at 1 and 3 months for these subjects. SF-36 physical health domains were significantly reduced for LV group subjects up to 6 months compared with the SV group and controls (p=0.00 - 0.02).
Conclusion. SV group subjects recovered adequately and spontaneously within 3 months of discharge. LV group subjects, however, had significant limitations in exercise capacity, muscle strength and physical components of QOL up to 6 months after discharge. Persistent impairment of function is related to duration of illness and immobility.
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