Trauma center designation and the decreasing incidence of post-traumatic acute respiratory distress syndrome: A potential guidepost for quality improvement

2011 ◽  
Vol 202 (6) ◽  
pp. 829-836 ◽  
Author(s):  
David S. Plurad ◽  
Scott Bricker ◽  
Peep Talving ◽  
Lydia Lam ◽  
Demetrios Demetriades
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Quality Improvement ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Trauma Center ◽  
Distress Syndrome ◽  
Post Traumatic

Prognostic factors for development of acute respiratory distress syndrome following traumatic injury – a systematic review and meta-analysis

2021 ◽  
pp. 2100857
Author(s):  
Alexandre Tran ◽  
Shannon M. Fernando ◽  
Laurent J. Brochard ◽  
Eddy Fan ◽  
Kenji Inaba ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Respiratory Distress Syndrome ◽  
Prognostic Factors ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Traumatic Injury ◽  
Clinical Risk Factors ◽  
Factors Associated ◽  
Post Traumatic

PurposeTo summarise the prognostic associations between various clinical risk factors and the development of the acute respiratory distress syndrome (ARDS) following traumatic injury.MethodsWe conducted this review in accordance with the PRISMA and CHARMS guidelines. We searched six databases from inception through December 2020. We included English language studies describing the clinical risk factors associated with the development of post-traumatic ARDS, as defined by either the American-European Consensus Conference or the Berlin definition. We pooled adjusted odds ratios for prognostic factors using the random effects method. We assessed risk of bias using the QUIPS tool and certainty of findings using GRADE methodology.ResultsWe included 39 studies involving 5 350 927 patients. We identified the amount of crystalloid resuscitation as a potentially modifiable prognostic factor associated with the development of post-traumatic ARDS (adjusted odds ratio [aOR] 1.19 for each additional liter of crystalloid administered within first 6 h after injury, 95% CI 1.15 to 1.24, high certainty). Non-modifiable prognostic factors with a moderate or high certainty of association with post-traumatic ARDS included increasing age, non-Hispanic white race, blunt mechanism of injury, presence of head injury, pulmonary contusion, or rib fracture; and increasing chest injury severity.ConclusionWe identified one important modifiable factor, the amount of crystalloid resuscitation within the first 24 h of injury, and several non-modifiable factors associated with development of post-traumatic ARDS. This information should support the judicious use of crystalloid resuscitation in trauma patients and may inform the development of a risk-stratification tools.

Early recovery from post-traumatic acute respiratory distress syndrome

2006 ◽  
Vol 26 (6) ◽  
pp. 376-379 ◽  
Author(s):  
Andreas Reske ◽  
Matthias Seiwerts ◽  
Alexander Reske ◽  
Udo Gottschaldt ◽  
Dierk Schreiter
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Early Recovery ◽  
Post Traumatic

Association of post-traumatic acute respiratory distress syndrome on poor prognosis: a single-center study

2020 ◽  
pp. 1-16
Author(s):  
Li Luo ◽  
Hao Tang ◽  
Qi Huang ◽  
Junyu Zhu ◽  
Dongpo Jiang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Hospital Stay ◽  
Poor Prognosis ◽  
Distress Syndrome ◽  
Icu Stay ◽  
Increased Risk ◽  
Post Traumatic

Abstract Objective: To determine the association of post-traumatic acute respiratory distress syndrome (ARDS) on poor prognosis, and provide a theoretical basis for the treatment of patients with post-traumatic ARDS in clinical practice. Methods: This was a retrospective study including trauma victims in the intensive care unit (ICU) of Daping Hospital. The patients were classified as having ARDS or non-ARDS, according to the Berlin definition. Subsequently, these patients were divided into subgroups, according to age, gender and injury site. The relationship between ARDS and prognosis was analyzed, including mechanical ventilation days, length of ICU stay, length of hospital stay, infection, sepsis, multiple organ dysfunction syndrome (MODS) and death. Results: There were 507 trauma patients, out of which 287 cases were with ARDS (56.61%). The duration of mechanical ventilation, ICU stay and hospital stay in the ARDS group was significantly longer than that in the non-ARDS group (5 days vs 3 days, 10 days vs 4 days, 30 days vs 27 days, respectively). In addition, ARDS was associated with an increased risk of infection (P<0.05; OR=4.17; 95%CI=2.72–6.41), sepsis (P<0.05; OR=3.45; 95%CI=2.28–5.22), and MODS (P<0.05; OR=2.82; 95%CI=1.67–4.72), but had no significant association with death (P>0.05). Similar results were found in the subgroup analyses. Conclusions: In conclusion, the prognosis of the patients with post-traumatic ARDS was worse; however, ARDS had little effect on death. Keywords: Trauma; ARDS; Poor Prognosis Continuous...

Outcomes of Post-Traumatic Acute Respiratory Distress Syndrome (ARDS) in Young Patients with and Without Extracorporeal Membrane Oxygenation (ECMO) at a Level-1 Trauma Center

2021 ◽  
Author(s):  
Hassan Al-Thani ◽  
Ammar Al-Hassani ◽  
Ayman El-Menyar ◽  
Mohammad Asim ◽  
Ibrahim Fawzy
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Odds Ratio ◽  
Distress Syndrome ◽  
Young Patients ◽  
Ecmo Support ◽  
Trauma Patients ◽  
Post Traumatic

Abstract Background We aimed to evaluate the outcomes of post-traumatic acute respiratory distress syndrome (ARDS) in young patients with and without Extracorporeal membrane oxygenation (ECMO) support. Methods A retrospective analysis was conducted for trauma patients who developed ARDS at a level I trauma facility between 2014 and 2020. Data were analyzed and compared between ECMO and non-ECMO group. Results We identified 85 patients with ARDS (22 patients had ECMO support and 63 matched patients managed by the conventional mechanical ventilation; 1:3 matching ratio). The two groups were comparable for age, sex, injury severity score, abbreviated injury score, shock index, SOFA score, and head injury. Kaplan Meier survival analysis showed that the survival in the ECMO group was initially close to that of the non-ECMO, however, during follow-up, the survival rate was better in the ECMO group, but did not reach statistical significance (Log-rank, p=0.43 and Tarone-Ware, p=0.37). Multivariable logistic regression analysis showed that acute kidney injury (AKI) (Odds ratio 13.03; 95% CI 3.17-53.54) and brain edema (Odds ratio 4.80; 95% CI 1.10-21.03) were independent predictors of mortality. Sub-analysis showed that in patients with severe Murray Lung Injury (MLI) scores, non-ECMO group had higher mortality than the ECMO group (100% vs 36.8%, p=0.004). Conclusion Although ARDS is uncommon in young trauma patients, it has a high mortality. ECMO therapy was used in a quarter of ARDS cases. AKI and brain edema were the predictors of mortality among ARDS patients. ECMO use did not worsen the outcome in trauma patients; however, the survival was better in those who had severe MLI and ECMO support. Further prospective study is needed to define the appropriate selection criteria for the use of ECMO to optimize the outcomes in trauma patients.

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