ArticleThe journal of trauma and acute care surgery2019
Predictors of postinjury acute respiratory distress syndrome: Lung injury persists in the era of hemostatic resuscitation.
Article in The journal of trauma and acute care surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 23 citations in OpenAlex.
- Elevating the standards of hypofibrinogenemia in trauma: Higher thresholds of admission fibrinogen predict mortality and organ dysfunction.Transfusion · 2026Article
- An Analysis of the Association of Whole Blood Transfusion With the Development of Acute Respiratory Distress Syndrome.Critical care medicine · 2025Article
- Combat Trauma-Related Acute Respiratory Distress Syndrome: A Scoping Review.Critical care explorations · 2022Article
- Predictors and outcomes of postoperative tracheostomy in patients undergoing acute type A aortic dissection surgery.BMC cardiovascular disorders · 2022Article
- Trauma, Metabolomics, Outcomes, and Secrets of the Sphinx.Journal of the American College of Surgeons · 2021Article
- Alarming Cargo: The Role of Exosomes in Trauma-Induced Inflammation.Biomolecules · 2021Review
- Natural and engineered chemokine (C-X-C motif) receptor 4 agonists prevent acute respiratory distress syndrome after lung ischemia-reperfusion injury and hemorrhage.Scientific reports · 2020Article
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAcute respiratory distress syndrome (ARDS) following trauma is historically associated with crystalloid and blood product exposure. Advances in resuscitation have occurred over the last decade, but their impact on ARDS is unknown. We sought to investigate predictors of postinjury ARDS in the era of hemostatic resuscitation.
methodsData were prospectively collected from arrival to 28 days for 914 highest-level trauma activations who required intubation and survived more than 6 hours from 2005 to 2016 at a Level I trauma center. Patients with ratio of partial pressure of oxygen to fraction of inspired oxygen of 300 mmHg or less during the first 8 days were identified. Two blinded expert clinicians adjudicated all chest radiographs for bilateral infiltrates in the first 8 days. Those with left-sided heart failure detected were excluded. Multivariate logistic regression was used to define predictors of ARDS.
resultsOf the 914 intubated patients, 63% had a ratio of partial pressure of oxygen to fraction of inspired oxygen of 300 or less, and 22% developed ARDS; among the ARDS cases, 57% were diagnosed early (in the first 24 hours), and 43% later. Patients with ARDS diagnosed later were more severely injured (ISS 32 vs. 20, p = 0.001), with higher rates of blunt injury (84% vs. 72%, p = 0.008), chest injury (58% vs. 36%, p < 0.001), and traumatic brain injury (72% vs. 48%, p < 0.001) compared with the no ARDS group. In multivariate analysis, head/chest Abbreviated Injury Score scores, crystalloid from 0 to 6 hours, and platelet transfusion from 0 to 6 hours and 7 to 24 hours were independent predictors of ARDS developing after 24 hours.
conclusionsBlood and plasma transfusion were not independently associated with ARDS. However, platelet transfusion was a significant independent risk factor. The role of platelets warrants further investigation but may be mechanistically explained by lung injury models of pulmonary platelet sequestration with peripheral thrombocytopenia. LEVEL OF EVIDENCE: Prognostic study, level IV.
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