Differences in degree, differences in kind: characterizing lung injury in trauma

The Journal of Trauma and Acute Care Surgery
Benjamin M HowardMitchell Jay Cohen

Abstract

Acute lung injury following trauma remains a significant source of morbidity and mortality. Although multiple trauma studies have used hypoxemia without radiographic adjudication as a surrogate for identifying adult respiratory distress syndrome (ARDS) cases, the differences between patients with hypoxemia alone and those with radiographically confirmed ARDS are not well described in the literature. We hypothesized that nonhypoxemic, hypoxemic, and ARDS patients represent distinct groups with unique characteristics and predictors. Laboratory, demographic, clinical, and outcomes data were prospectively collected from 621 intubated, critically injured patients at an urban Level 1 trauma center from 2005 to 2013. Hypoxemia was defined as PaO2/FIO2 ratio of 300 or lower. ARDS was adjudicated using Berlin criteria, with blinded two-physician consensus review of chest radiographs. Group comparisons were performed by hypoxemia and ARDS status. Logistic regression analyses were performed to separately assess predictors of hypoxemia and ARDS. Of the 621 intubated patients, 64% developed hypoxemia; 46% of these hypoxemic patients developed ARDS by chest radiograph. Across the three groups (no hypoxemia, hypoxemia, ARDS), there were no si...Continue Reading

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Citations

Aug 27, 2015·The Journal of Trauma and Acute Care Surgery·Carolyn M HendricksonMitchell Jay Cohen
Apr 14, 2016·Critical Care : the Official Journal of the Critical Care Forum·Rolf RossaintDonat R Spahn
Feb 18, 2016·The Journal of Trauma and Acute Care Surgery·Carolyn M HendricksonMitchell J Cohen
Jan 27, 2018·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Min Woo KimSo Yeon Kong
Aug 18, 2018·Critical Care Medicine·Elizabeth Y KillienFrederick P Rivara
Nov 1, 2018·Critical Care Medicine·Elizabeth Y KillienFrederick P Rivara
Jan 12, 2019·The Journal of Trauma and Acute Care Surgery·Elizabeth Y KillienFrederick P Rivara
Apr 30, 2019·The Journal of Trauma and Acute Care Surgery·Lucy Z KornblithMitchell Jay Cohen
Mar 29, 2019·Critical Care : the Official Journal of the Critical Care Forum·Donat R SpahnRolf Rossaint
Mar 16, 2019·Nature Reviews. Disease Primers·Michael A MatthayCarolyn S Calfee
Oct 2, 2021·PloS One·Sharven TaghaviJay Kolls

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