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Prevention and treatment of post-traumatic acute respiratory distress syndrome

University of Southern California, 1200 North State Street, Room 9900, Los Angeles, CA, USA 90033-4525, rjbenfield{at}mac.com

Joseph DuBose

University of Southern California, 1200 North State Street, Room 9900, Los Angeles, CA, USA 90033-4525

Demetrios Demetriades

University of Southern California, 1200 North State Street, Room 9900, Los Angeles, CA, USA 90033-4525

Post-Traumatic Acute Respiratory Distress Syndrome (ARDS) is a major cause of morbidity and mortality in the acutely injured patient. The American-European Consensus Conference Report established the most widely accepted definition of ARDS in 1994. In recent years it appears the incidence and impact of the disease are on the decline. This article reviews strategies to prevent and treat post-traumatic ARDS. Well-accepted, proven strategies include lung protective ventilation strategies, as well as conservative transfusion and crystalloid resuscitation policies and the adoption of leukoreduction techniques. Other modalities including hypertonic saline resuscitation, use of albumin and diuretics, positive end expiratory pressure, high-frequency ventilation, prone positioning, recruitment maneuvers, extracorporeal membrane oxygenation, corticosteroids, exogenous surfactant, and inhaled nitric oxide are also reviewed.

Key Words: Acute Respiratory Distress Syndrome (ARDS) • Acute Lung Injury (ALI) • trauma • mechanical ventilation • blood transfusion • resuscitation • critical care • prevention

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