Management of Thoracic Trauma in Intensive Care Unit in Togo: A Particular Reference to Sylvanus Olympio University Hospital of Lome

Author(s): Essohanam Tabana Mouzou, Sarakawabalo Assenouwe, Damessane Lamboni, Kondo Bignandi, Abd El Kader Moumouni, Pwèmdéou Efalou, Ibrahim Kai-Samba, Hamza Doles Sama, Pikabalo Tchetike, Pilakimwé Egbohou, Magnoudewa Poko, Maliki Akondo, Gnimdo Mawa-eya Akala Yoba, Gnankoulaba Songne

Background

The Management of thoracic trauma (TT) requires often life-saving cares in intensive care units (ICUs). This study aimed to analyze this management in a Togolese ICU.

Materials and methods

A retrospective and descriptive study was carried out in the ICU of Sylvanus Olympio University Hospital of Lomé, over a six-year period. The records of TT patients were analyzed from registers using Epi-info 7.2.4 software.

Results

One hundred and ninety-five patients (195) were admitted with TT (5.1% of ICU admission), with 187 selected for the research. Their mean age was 38.1 ± 13 years and sex-ratio = 6.8. Road Traffic Accidents (RTA) were the most frequent causes (87.2%). Patients had respiratory distress (62.6%), severe coma (24.6%), and hemorrhagic shock (4.8%). It was polytrauma in 92.5% of cases with 75.9% of cranio-encephalic injuries. Fifty patients underwent surgery. Resuscitation included mainly analgesia (100%), oxygen therapy (65.8%), blood transfusion (49.7%), fluid resuscitation (21.9%), mechanical ventilation (15%), and decompression needle thoracostomy (11.2%). The mean length for ICU stay was 12.7 ± 6 days. At least one complication occurred in 55.8% of patients: sepsis in 43.3%, bronchopulmonary infection in 32.1%, hemorrhagic shock in 16.6% and septic shock in 15%. Eighty-four patients (44.9%) died, mainly of septic shock (30.9%). The management faced shortcomings such as inadequate aseptic conditions, unavailability of blood gas test, insufficiency of monitors and ventilators.

Conclusion

TT patients presented to ICU with associated injuries. The management was successful in most cases, but faced challenges. It is necessary to improve equipment and management protocols.