Predictive factors of nebulized morphine failure in North-African patients with chest trauma: a prospective pilot study.

IF 2.9 3区医学 Q2 RESPIRATORY SYSTEM

Expert Review of Respiratory Medicine Pub Date : 2022-10-01 Epub Date: 2022-10-05 DOI:10.1080/17476348.2022.2131543

Hela Attia, Helmi Ben Saad, Karim Masmoudi, Imen Bannour, Mouna Ouaz, Kais Gardabbou, Ali Majdoub

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引用次数: 1

Abstract

Objective: To determine the predictive factors of nebulized morphine (nMOR) failure in patients with chest trauma.

Research design and methods: This was an interventional clinical study. Patients admitted with isolated chest trauma with a pain visual analog score > 4 were included. Each patient received 10 mg nMOR. If pain was still > 4 after 10 minutes of nebulization, the latter was repeated every 10 minutes until pain was relieved (i.e. ≤ 4). If pain was > 4 at 30 minutes, nMOR was considered a failure. Patients were divided into two groups: MOR (+) and MOR (-) (good response to and nMOR failure, respectively).

Results: Seventy-five patients were included. Analysis of the risk factors revealed that road traffic accidents (relative risk (RR): 0.117 [0.031-0.443]; p = 0.002), number of fractured ribs > 4 (RR: 0.317 [0.092-0.543]; p = 0.006), bilateral injury (RR: 0.114 [0.037-0.349]; p < 0.001), flail chest (RR: 0.120 [0.037-0.386]; p < 0.001), hemothorax (RR: 0.203 [0.062-0.660]; p = 0.008), pulmonary contusion (RR: 0.202 [0.069-0.589]; p = 0.003), and pain at admission > 7 (RR: 0.363 [0.147-0.579]; p = 0.004) were predictors of nMOR failure.

Conclusion: Our results can help optimize the analgesic management of chest trauma patients by identifying the most eligible patients to benefit from nMOR.

Clinical trial registration: www.clinicaltrials.gov identifier is NCT03580187.

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北非胸外伤患者吗啡雾化失效的预测因素:一项前瞻性试点研究。

目的:探讨胸外伤患者雾化吗啡(nMOR)失效的预测因素。研究设计与方法:本研究为介入性临床研究。纳入了疼痛视觉模拟评分> 4的孤立性胸部创伤患者。每例患者接受10 mg nMOR治疗。如果在雾化10分钟后疼痛仍然> 4，则每10分钟重复一次，直到疼痛缓解(即≤4)。如果在30分钟时疼痛> 4，则认为nMOR失败。患者分为MOR(+)组和MOR(-)组(分别为反应良好组和nMOR失败组)。结果:纳入75例患者。危险因素分析表明:道路交通事故相对危险度(RR): 0.117 [0.031-0.443];p = 0.002)，骨折肋骨数> 4 (RR: 0.317 [0.092-0.543];p = 0.006)，双侧损伤(RR: 0.114 [0.037-0.349];p 7 (RR: 0.363 [0.147-0.579];p = 0.004)是nMOR失败的预测因子。结论:我们的研究结果可以通过确定最适合从nMOR中获益的患者来帮助优化胸部创伤患者的镇痛管理。临床试验注册:www.clinicaltrials.gov标识符:NCT03580187。

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来源期刊

Expert Review of Respiratory Medicine RESPIRATORY SYSTEM-

CiteScore

6.80

自引率

2.60%

发文量

期刊介绍： Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity