Die kontinuierliche laterale Rotationstherapie bei Patienten mit Thoraxtrauma: Eine Analyse aus dem TraumaRegister DGU®

TY - JOUR

T1 - Die kontinuierliche laterale Rotationstherapie bei Patienten mit Thoraxtrauma: Eine Analyse aus dem TraumaRegister DGU®

AU - Defosse, J

AU - Grensemann, J

AU - Gerbershagen, M U

AU - Paffrath, T

AU - Böhmer, A

AU - Joppich, R

AU - Lefering, R

AU - Wappler, F

AU - Schieren, M

AU - TraumaRegister DGU

PY - 2020/4

Y1 - 2020/4

N2 - BACKGROUND: Patients with severe thoracic trauma often receive continuous lateral rotational bed therapy (CLRT) for the treatment of lung contusions. In this study, the effects of CLRT on mortality, morbidity and length of stay (LOS) in the intensive care unit (ICU) and in the hospital were evaluated.METHODS: Retrospective data from the TraumaRegister DGU® were analysed, focusing on patients with severe thoracic trauma. Patients treated with CLRT were compared to a control group with comparable trauma severity who had received conventional therapy.RESULTS: A total of 1476 patients (239 with CLRT, 1237 without CLRT) were included in this study. Both groups were similar for demographic characteristics. The median CLRT duration was 6 (4-10) days. Patients receiving CLRT were ventilated for 17 (10-26) days compared to 14 (8-22) days (p = 0.001) in the control group. The ICU length of stay differed significantly (CLRT: 23 [14-32] days; control: 19 [13-28] days; p = 0.002). Also, organ failure occurred more frequently in patients treated with CLRT (CLRT: 76.6%, control: 67.6%; p = 0.006). No differences could be detected regarding mortality rates, multiple organ failure and hospital LOS.CONCLUSIONS: The results of this retrospective analysis fail to detect a benefit for CLRT therapy in trauma patients. Considering inherent limitations of retrospective studies, caution should be exerted when interpreting these results. Further research is warranted to confirm these findings in a prospective trial.

AB - BACKGROUND: Patients with severe thoracic trauma often receive continuous lateral rotational bed therapy (CLRT) for the treatment of lung contusions. In this study, the effects of CLRT on mortality, morbidity and length of stay (LOS) in the intensive care unit (ICU) and in the hospital were evaluated.METHODS: Retrospective data from the TraumaRegister DGU® were analysed, focusing on patients with severe thoracic trauma. Patients treated with CLRT were compared to a control group with comparable trauma severity who had received conventional therapy.RESULTS: A total of 1476 patients (239 with CLRT, 1237 without CLRT) were included in this study. Both groups were similar for demographic characteristics. The median CLRT duration was 6 (4-10) days. Patients receiving CLRT were ventilated for 17 (10-26) days compared to 14 (8-22) days (p = 0.001) in the control group. The ICU length of stay differed significantly (CLRT: 23 [14-32] days; control: 19 [13-28] days; p = 0.002). Also, organ failure occurred more frequently in patients treated with CLRT (CLRT: 76.6%, control: 67.6%; p = 0.006). No differences could be detected regarding mortality rates, multiple organ failure and hospital LOS.CONCLUSIONS: The results of this retrospective analysis fail to detect a benefit for CLRT therapy in trauma patients. Considering inherent limitations of retrospective studies, caution should be exerted when interpreting these results. Further research is warranted to confirm these findings in a prospective trial.

KW - English Abstract

KW - Journal Article

U2 - 10.1007/s00063-019-0565-8

DO - 10.1007/s00063-019-0565-8

M3 - SCORING: Zeitschriftenaufsatz

C2 - 30923850

VL - 115

SP - 222

EP - 227

JO - MED KLIN-INTENSIVMED

JF - MED KLIN-INTENSIVMED

SN - 2193-6218

IS - 3

ER -