Minimally Invasive Intramedullary Fixation of Middle third clavicular Fractures Through the Medial Entry by Titanium Elastic Nailing System (TENS)

Authors

1 Anesthesia & Intensive Care and Pain Management, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

2 Orthopedic Surgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

3 Emergency and Critical Care, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

Abstract

Background: Serum phosphate levels below 2.5 mg/dl are considered hypophosphatemia, and they are common in critically sick cases. Hypophosphatemia can impair respiratory drive, muscle contractility, and myocardial function. Aim and objectives: To evaluate the success rate in weaning from mechanical ventilation in patients suffering from hypophosphatemia. Methods: This is prospective observational clinical research conducted on 45 adult patients on mechanical ventilation due to traumatic brain injury, septic shock, neurology disease, post-operative and post–arrest from March 2023 to March 2024 at Al-Azhar University Hospitals (El-Hussein and Bab El-Sharia University Hospitals) in Cairo. Patients admitted to the intensive care unit (ICU) for more than seven days had their serum phosphate levels measured when weaning. The goal was to evaluate the weaning success, the mortality rate, and the duration of stay. Results: The hypophosphatemia group had a considerably reduced success rate of weaning and median survival time compared to the standard group (P<0.05). The hypophosphatemia group exhibited significantly increased ventilation time and death rate compared to the standard group (P <0.05). Conclusions: There was evidence of a link between hypophosphatemia and difficulty weaning critically ill patients from mechanical ventilation. The weaning success rate and survival time were significantly lower in the group with hypophosphatemia, and the mortality rate and time of ventilation were significantly higher in the group with hypophosphatemia.

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