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Open Access Highly Accessed Review

Acute lung injury and the acute respiratory distress syndrome in the injured patient

Magdalena Bakowitz1*, Brandon Bruns2 and Maureen McCunn3

Author Affiliations

1 Department of Anesthesiology & Critical Care, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA

2 Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA

3 Department of Anesthesiology & Critical Care, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA

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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2012, 20:54  doi:10.1186/1757-7241-20-54

Published: 10 August 2012

Abstract

Acute lung injury and acute respiratory distress syndrome are clinical entities of multi-factorial origin frequently seen in traumatically injured patients requiring intensive care. We performed an unsystematic search using PubMed and the Cochrane Database of Systematic Reviews up to January 2012. The purpose of this article is to review recent evidence for the pathophysiology and the management of acute lung injury/acute respiratory distress syndrome in the critically injured patient. Lung protective ventilation remains the most beneficial therapy. Future trials should compare intervention groups to controls receiving lung protective ventilation, and focus on relevant outcome measures such as duration of mechanical ventilation, length of intensive care unit stay, and mortality.

Keywords:
Lung injury; Acute lung injury (ALI); Acute respiratory distress syndrome (ARDS); Trauma; Injury; Prone positioning; Extracorporeal membrane oxygenation (ECMO); Rib plating; Rib open reduction internal fixation; Flail chest; High-frequency oscillatory ventilation (HFOV); Airway pressure release ventilation (APRV)