The Decreasing Incidence of Late Posttraumatic Acute Respiratory Distress Syndrome: the Potential Role of Lung Protective Ventilation and Conservative Transfusion Practice

• DOI: 10.1097/ta.0b013e318068b1ed
• Publication Date: 2007-07-10T08:03:37Z
• Authors: David Plurad; Mathew Martin; Donald Green; Ali Salim; Kenji Inaba; Howard Belzberg; Demetrios Demetri...; Peter Rhee
• Keywords: Diffuse alveolar damage

A reduction in the incidence of posttraumatic Acute Respiratory Distress Syndrome (ARDS) has been demonstrated. It is hypothesized that ventilation strategies and restrictive transfusion policies are contributory. The purpose this study to examine changes parameters over time their associations with late ARDS.The surgical intensive care unit blood bank databases from a Level I center during 6-year period were analyzed. All mechanically ventilated trauma patients screened for ARDS onset after 48 hours admission (late ARDS). Demographic, injury, resuscitation, parameters, data extracted. Variables analyzed significant duration study, independent determined.There 2,346 eligible 192 (8.2%) them met criteria ARDS. There was decrease by year (14.9% 2000 3.8% 2005). When comparing first second half there percentage transfused packed red cells (49.0% versus 40.7%), peak inspiratory pressure > or = 30 mm Hg (64.9% 50.1%), tidal volume/kg 10 mL/kg (39.6% 21.8%). Early transfusions, Hg, fluid balance 2 L independently associated increasing use potentially limit elevations early pressures decreased