title: [Serial rib fractures: a differentiated treatment concept, illustrated by 59 severely injured intensive care patients].
abstract: In a group of 59 consecutive ICU trauma patients with blunt chest injury and considerable injury severity (ISS = 29) a three-staged therapeutic approach was followed, depending seriousness of chest injury, overall injury severity and age. Stage 1: i.v. analgesia and conventional respiratory therapy. Stage 2: continuous epidural analgesia (local anesthetics and opiates) and intermittent CPAP (continuous positive airway pressure) by face mask. Stage 3: Endotracheal intubation and internal pneumatic stabilization of the chest, preferably spontaneous breathing. Only 44% of the patients needed intubation, and none died. The authors recommend this three-step approach towards blunt chest injury and serial rib fractures.
authors.affiliation: Interdisziplinäre Intensivstation, Chur.
authors.forename: A
authors.initials: A
authors.lastname: Frutiger
authors.forename: A
authors.initials: A
authors.lastname: Leutenegger
authors.forename: T
authors.initials: T
authors.lastname: Rüedi
mesh_terms: D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D009104:Multiple Trauma / Q000628:therapy*; D012189:Retrospective Studies; D012253:Rib Fractures / Q000628:therapy*; D013898:Thoracic Injuries / Q000628:therapy*; D014949:Wounds, Nonpenetrating / Q000628:therapy
vernacular_title: Rippenserienfrakturen: ein differenziertes Behandlungskonzept, dargestellt an 59 schwerverletzten Intensivpatienten.