{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T21:49:54Z","timestamp":1769636994941,"version":"3.49.0"},"reference-count":16,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,29]],"date-time":"2021-10-29T00:00:00Z","timestamp":1635465600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>This study aims to define possible predictors of the need of invasive and non-invasive ventilatory support, in addition to predictors of mortality in patients with severe thoracic trauma. Data from 832 patients admitted to our trauma center were collected from 2010 to 2017 and retrospectively analyzed. Demographic data, type of respiratory assistance, chest injuries, trauma scores and outcome were considered. Univariate analysis was performed, and binary logistic regression was applied to significant data. The injury severity score (ISS) and the revised trauma score (RTS) were both found to be predictive factors for invasive ventilation. Multivariate analysis of the anatomical injuries revealed that the association of high-severity thoracic injuries with trauma in other districts is an indicator of the need for orotracheal intubation. From the analysis of physiological parameters, values of systolic blood pressure, lactate, and Glasgow coma scale (GCS) score indicate the need for invasive ventilatory support. Predictive factors for non-invasive ventilation include: RTS, ISS, number of rib fractures and presence of hemothorax. Risk factors for death were: age over 65, the presence of bilateral rib fractures, pulmonary contusion, hemothorax and associated head trauma. In conclusion, the need for invasive ventilatory support in thoracic trauma is associated to the patient\u2019s systemic severity. Non-invasive ventilation is a supportive treatment indicated in physiologically stable patients regardless of the severity of thoracic injury.<\/jats:p>","DOI":"10.3390\/life11111154","type":"journal-article","created":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T22:22:24Z","timestamp":1635805344000},"page":"1154","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Predictive Factors of Ventilatory Support in Chest Trauma"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4030-6656","authenticated-orcid":false,"given":"Silvia","family":"Fattori","sequence":"first","affiliation":[{"name":"General Surgery-Trauma Team, Niguarda Hospital, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa","family":"Reitano","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Translational Medicine, Maggiore della Carit\u00e0 Hospital, University of Eastern Piedmont, 28100 Novara, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osvaldo","family":"Chiara","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplants-State, University of Milan-General Surgery-Trauma Team, Niguarda Hospital, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Cimbanassi","sequence":"additional","affiliation":[{"name":"General Surgery-Trauma Team, Niguarda Hospital, 20162 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,29]]},"reference":[{"key":"ref_1","unstructured":"Chiara, O., and Cimbanassi, S. (2008). Protocolli per la Gestione Intraospedaliera del Trauma Maggiore, Elsevier Masson."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0039-6109(16)44730-4","article-title":"Epidemiology of Chest Trauma","volume":"69","author":"LoCicero","year":"1989","journal-title":"Surg. Clin. North Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/S0749-0704(03)00098-8","article-title":"Blunt thoracic trauma: Flail chest, pulmonary contusion, and blast injury","volume":"20","author":"Wanek","year":"2004","journal-title":"Crit. Care Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1007\/s00113-018-0523-6","article-title":"Anesthesia, ventilation and pain treatment in thoracic trauma","volume":"121","author":"Weigeldt","year":"2018","journal-title":"Unfallchirurg"},{"key":"ref_5","first-page":"9","article-title":"Chest trauma","volume":"47","author":"Gilart","year":"2011","journal-title":"Arch. 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Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/149798\/9789241508018_eng.pdf."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.cjtee.2020.04.003","article-title":"Blunt trauma related chest wall and pulmonary injuries: An overview","volume":"23","author":"Dogrul","year":"2020","journal-title":"Chin. J. Traumatol."},{"key":"ref_11","unstructured":"Moore, E.E., Feliciano, D.V., and Mattox, K.L. (2017). Trauma, 8th Edition, McGraw-Hill Education. [8th ed.]."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"18-8","DOI":"10.1186\/s13017-020-00297-1","article-title":"Motorcycle-related trauma:effects of age and site of injuries on mortality. A single-center, retrospective study","volume":"15","author":"Granieri","year":"2020","journal-title":"World J. Emerg. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"R142","DOI":"10.1186\/cc12821","article-title":"Safety and efficacy of noninvasive ventilation in patients with blunt chest trauma: A systematic review","volume":"17","author":"Duggal","year":"2013","journal-title":"Crit. Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"88","DOI":"10.5152\/TJAR.2018.46762","article-title":"Non-Invasive Mechanical Ventilation in Critically Ill Trauma Patients: A Systematic Review","volume":"46","author":"Schreiber","year":"2018","journal-title":"Turk. J. Anesth. Reanim."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1378\/chest.09-1114","article-title":"Noninvasive Ventilation Reduces Intubation in Chest Trauma-Related Hypoxemia: A Randomized Clinical Trial","volume":"137","author":"Hernandez","year":"2010","journal-title":"Chest"},{"key":"ref_16","first-page":"193","article-title":"Pathophysiology and management of the flail chest","volume":"70","author":"Davignon","year":"2004","journal-title":"Minerva Anestesiol."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/11\/11\/1154\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:22:36Z","timestamp":1760167356000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/11\/11\/1154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,29]]},"references-count":16,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["life11111154"],"URL":"https:\/\/doi.org\/10.3390\/life11111154","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,29]]}}}