Abstract
Clinical predisposition to respiratory failure was investigated retrospectively in 393 trauma patients who were treated in Chiba Emergency Medical Center during a 6-year period from 1984 to 1990. Patients were classified into 4 groups according to the site of injury, namely, an extremity and pelvic injury group (144 cases, Group I ), an abdominal injury group (71 cases, Group II ), a thoracic injury group (98 cases, Group III) and a brain injury group (80 cases, Group IV). Location and severity of injury, shock index, duration of shock and amount of blood transfused were analyzed. The results were as follows: (1) The rate of development of respiratory failure was 18.1% in Group I, 26.8% in Group II, 46.9% in Group III and 10.0% in Group IV. (2) In Groups I, II and III, there were statistically significantly higher ISS's, TI's and APACHE II's in cases with respiratory failure. (3) In Groups I and II, there were statistically significantly higher shock indices in cases with respiratory failure. (4) In Groups I, II and III, when the duration of shock exceeded 2 hours, the rate of respiratory failure increased remarkably. (5) In Group I, the amount of blood transfused significantly affected the rate of respiratory failure. (6) In Group I, a fall in GCS was associated with a significantly higher rate of respiratory failure. (7) In Group IV, no potential predisposition was related to the development of respiratory failure.
