الفهرس 
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Abstract
Background: According to WHO trauma causes about 5.8 million deaths every year and it is the leading cause of death in people aged from 1 to 46 years. Blunt chest trauma causes 25% of traumatic deaths. It is commonly associated with multiple organ damage which leads to catastrophic patient outcome. Blunt chest trauma is more common than penetrating chest trauma and it is mainly caused by road traffic Chest injuries can affect the thoracic wall (e.g., rib, sternum fracture) as well as thoracic organs (e.g., lung, heart, vessels) to a different extent. Arterial blood gas (ABG) studies report the degrees of acidemia, hypercarbia, and hypoxemia, which depend on cardiopulmonary status at the time of collection. ABG analysis does not replace physical diagnosis however, it may be useful in evaluating hypoxia and hypercarbia and respiratory acidosis. The aim of the work: Our study was designed to determine the prognostic value of ABG measurement in patients with blunt chest trauma and the relation with different outcomes. Patients: Our study done on 100 patients arrived to emergency department (ED) in Emergency Hospital-Mansoura University during the period from 1-8-2019 to 1-8-2020. All adult patients over 18yeas old with poly-trauma, blunt trauma to chest and thoraco-abdominal area from both genders are included in the study. Our study excluded shocked patients from the start as patients which were intubated prior to arrival to the hospital or patients which need immediate chest decompression for management of tension pneumothorax. Patients with underlying pulmonary disease and cardiac patients with heart failure were also excluded. Patients needed urgent surgery or death before CT chest, patients with penetrating chest injuries, pregnant females and Patients below 18 years old were also excluded. Methods: All patients were subjected to careful history including age, gender, mode and time of trauma, arrival and resuscitation. Clinical examination: A. Primary survey including: Airway. Breathing. Circulation. Disability: Glasgow coma scale (GCS) .Exposure of the patient to detect other injuries. B. Secondary survey: Full clinical examination of all body. GCS on admission after primary respiratory and hemodynamic stabilization. Laboratory and Radiological investigations: Full laboratory analysis including: Arterial blood gases (ABG) in room air, Combined ABG calculations. Routine blood investigations which include: Complete blood count (CBC), serum creatinine, GFR. Radiological analysis including : Abdominal and chest ultrasound . Chest X ray: To show the ribs and lung parenchyma. CT chest. Results& Conclusion: ABG and combined ABG measurements are strongly reflecting the clinical situation of chest trauma patients. It can predict longer length of hospital stay. Blunt chest trauma causes 25% of traumatic deaths. It is commonly associated with multiple organ damage. It is more common than penetrating chest trauma and mainly caused by road traffic accidents. Arterial blood gases are routine investigations in blunt chest trauma.ABG values and combined ABG values are statistically significant in determination of patients admitted to ward versus others admitted in ICU. Recommendations: Emergency physicians should have high index of suspicion of chest trauma and be able to refer promptly. Lab tests including arterial blood gases are routine investigations in blunt chest trauma. PCO2 values are predictors of respiratory failure, need of intubation and mechanical ventilation.