TITLE

Acute Respiratory Distress Syndrome in Blunt Trauma; Identification of Independent Risk Factors

AUTHOR(S)
Miller, Preston R.; Kilgo, Patrick D.; Croce, Martin A.; Scott, John; Fabian, Timothy C.
PUB. DATE
October 2002
SOURCE
American Surgeon;Oct2002, Vol. 68 Issue 10, p845
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Acute respiratory distress syndrome (ARDS) is a major contributor to morbidity and mortality in trauma patients. Although many injuries and conditions are believed to be associated with ARDS independent risk factors in trauma patients and their relative importance in development of the syndrome are undefined. The aim of this project is to identify independent risk factors for the development of ARDS in blunt trauma patients and to examine the contributions of each factor to ARDS development. Patients with ARDS were identified from the registry of a Level I trauma center over a 4.5-year period. Records were reviewed for demographics, injury characteristics, transfusion requirements, and hospital course. Variables examined included age >65 years, Injury Severity Score (ISS) >25, hypotension on admission (systolic blood pressure <90), significant metabolic acidosis (base deficit <-5.0), severe brain injury as shown by a Glasgow Coma Scale score (GCS) <8 on admission, 24-hour transfusion requirement >10 units packed red blood cells, pulmonary contusion (PC), femur fracture, and major infection (pneumonia, empyema, or intraabdominal abscess). Both univariate and stepwise logistic regression were used to identify independent risk factors, and receiver operating characteristic curve (ROC) analysis was used to determine the relative contribution of each risk factor. A total of 4397 patients having sustained blunt trauma were admitted to the intensive care unit and survived >24 hours between October 1995 and May 2000. Of these patients 200 (4.5%) developed ARDS. All studied variables were significantly associated with ARDS in univariate analyses. Stepwise logistic regression, however, demonstrated age >65 years, ISS >25, hypotension on admission, 24-hour transfusion requirement >10 units, and pulmonary contusion as independent risk factors, whereas admission metabolic acidosis, femur fracture, infection, and severe brain injury were not. Using a model based on the...
ACCESSION #
7744145

 

Related Articles

  • Utilisation of high-frequency oscillatory ventilation in blunt thoracic trauma. Scarborough, John E; Vaslef, Steven N // Trauma;Oct2010, Vol. 12 Issue 4, p247 

    No abstract available.

  • Update on acute respiratory distress syndrome. Moss, Marc // Cortlandt Forum;01/25/97, Vol. 10 Issue 1, p217 

    Presents an update on acute respiratory distress syndrome. Description of the disease; Incidence and prevalence of the disease; Clinical features of the disease; People at risk for the disease; Best mode of mechanical ventilation; Medical therapies; Fluid management; Disease outcome.

  • Therapeutic potential of mesenchymal stromal cells in the treatment of ARDS. Huppert, Laura A; Liu, Kathleen D; Matthay, Michael A // Transfusion;Feb2019, Vol. 59 Issue 2, p869 

    No abstract available.

  • The harm of high-frequency oscillatory ventilation (HFOV) in ARDS is not related to a high baseline risk of acute cor pulmonale or short-term changes in hemodynamics. Angriman, Federico; Ferreyro, Bruno L.; Donaldson, Lachlan; Cuthbertson, Brian H.; Ferguson, Niall D.; Bollen, Casper W.; Bachman, Thomas E.; Lamontagne, Fran├žois; Adhikari, Neill K. J. // Intensive Care Medicine;Jan2020, Vol. 46 Issue 1, p132 

    The acute respiratory distress syndrome (ARDS) may encompass sub-populations that respond differently to treatments [[1]]. The hypothesized effect modifier (risk of RV failure) was defined by the acute cor pulmonale (ACP) score measured at baseline (pre-randomization) [[5]].

  • Bivalirudin/heparin: Haematological disorders: 13 case reports.  // Reactions Weekly;Jun2019, Vol. 1756 Issue 1, p80 

    A 71-year-old woman developed pruritus and acneiform skin rash during treatment with erlotinib for lung adenocarcinoma. Additionally, the acneiform skin rash and pruritus worsened following concomitant administration of erlotinib and aprepitant for lung adenocarcinoma.

  • Herpesviridae reactivation for poor outcome in ARDS patients with ECMO: criminal or witness? Huang, Huixue; He, Hangyong // Annals of Intensive Care;1/28/2020, Vol. 10 Issue 1, p1 

    We read with interest of the report by Hraiech and colleagues [[1]] about the I Herpesviridae i reactivation among non-immunocompromised critically ill patients with acute respiratory distress syndrome (ARDS) supported with extracorporeal membrane oxygenation (ECMO). Within all ARDS patients, by...

  • SARS Bulletin from Hong Kong: 30 March-4 April 2003. Cheng, V.C.C.; Peris, M.; Yuen, K.Y. // Clinical Infectious Diseases;4/15/2003, Vol. 36 Issue 8, piii 

    Presents a bulletin about severe acute respiratory syndrome (SARS) from infectious disease physicians affiliated with hospitals in Hong Kong, China. Confirmation that the virus was a coronavirus and that SARS patients demonstrated a specific antibody response against the infected cell lines.

  • structure-based drug design: A common cure for SARS? Ellis, Clare // Nature Reviews Drug Discovery;Jul2003, Vol. 2 Issue 7, p509 

    Reports on a study conducted by Rolf Hilgenfeld and colleagues, which examined coronavirus main proteinase structure as a basis for design of drugs to fight severe acute respiratory syndrome (SARS). Crystal structure of the main proteinase; Characteristics of a peptide inhibitor called AG7088,...

  • Correction to: Focus on ventilation and ARDS: recent insights. De Jong, Audrey; Jaber, Samir; Ferguson, Niall D. // Intensive Care Medicine;Jan2020, Vol. 46 Issue 1, p152 

    The original version of this article unfortunately contained a mistake.

  • Corticosteroids in pediatric ARDS: all cards on the table. Schwingshackl, Andreas; Meduri, Gianfranco; Kimura, Dai; Cormier, Stephania; Anand, Kanwaljeet; Meduri, Gianfranco Umberto; Cormier, Stephania A; Anand, Kanwaljeet J S // Intensive Care Medicine;Nov2015, Vol. 41 Issue 11, p2036 

    A letter to the editor is presented in response to articles in a 2015 issue including "Corticosteroid Exposure in Pediatric Acute Respiratory Distress Syndrome," by N. Yehya and colleagues and "Corticosteroids for Paediatric ARDS: Unjustified--Even Unjustifiable?," by M. J. Peters and colleagues.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics