Acute Respiratory Distress Syndrome in Patients after Blunt Thoracic Trauma: The Influence of Hyperbaric Oxygen Therapy
The rate of mortality from acute respiratory distress syndrome (ARDS) has reportedly reached as high as 50–75%.1−3 The risk of ARDS development increases after severe blunt thoracic trauma (BTT) because of a higher likelihood for lung contusion4 and acute depression of cardiac function.5, 6 Monitoring of oxygen transport in patients with ARDS has shown that oxygen delivery and consumption were significantly higher in the survivors compared to nonsurvivors.7 This suggests that maintenance of oxygen delivery at optimal levels can potentially enable the reversal of ARDS.8 In cases of severe BTT, these oxygen transport variables may be induced by early cardiorespiratory dysfunction6, 9 which requires inotropic support.6, 8, 10 On the strength of these data, it is reasonable to conclude that the prevention and correction of oxygen deficiency are basic to intensive care during ARDS.
KeywordsPlacebo Depression Lactate Neurol Stein
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- 2.P. Krafft, P. Fridrich, T. Pemerstorfer, R. D. Fitzgerald, D. Koc, B. Schneider, A. F. Hammerle, and H. Steltzer, The acute respiratory distress syndrome: definitions, severity and clinical outcome. An analysis of 101 clinical investigations, Intensive Care Med. 22, 519–529 (1996).PubMedCrossRefGoogle Scholar
- 5.G. G. Rogatskii, Interrelation of cardiodynamics and pulmonary gas exchange in an experimental model of the acute respiratory failure syndrome, Biull. Ekrp. Biol. Med. 98, 273–275 (1984) (Russian).Google Scholar
- 11.C. S. Ray, B. Green, and P. Cianci, Hyperbaric oxygen therapy in bum patients with adult respiratory distress syndrome, Undersea Biomed. Res. 16 (Suppl.), 81 (1989).Google Scholar
- 12.E. G. Damon and R. K. Jones, Hyperbaric medicine in the treatment of thoracic trauma, Physiologist 14, 127 (1971).Google Scholar
- 13.G. G. Rogatskii, M. B. Vainshtein, and T. V. Sevost’ianova, Use of hyperbaric oxygenation to correct an acute experimental respiratory insufficiency syndrome, Biull. Eksp. Biol. Med. 105, 410411 (1988) (Russian).Google Scholar
- M. H. Bishop, J. Jorgens, W. C. Shoemaker, P. L. Appel, A. Fleming, D. Williams, G. Jackson, C. J. Wo, L. Babb, and T. Manning, et al.,The relationship between ARDS, pulmonary infiltration, fluid balance, and hemodynamics in critically ill surgical patients, Am. Surg. 57, 785–792 (1991).Google Scholar
- 19.K. S. Johnson, M. H. Bishop, C. M. 2. Stephen, J. Jorgens, W. C. Shoemaker, S. K. Shori, G. Ordog, H. Thadepalli, P. L. Appel, and H. B. Kram, Temporal patterns of radiographic infiltration in severely traumatized patients with and without adult respiratory distress syndrome, J. Trauma 36, 644–650 (1994).Google Scholar
- I. Boerema, N. G. Meyne, W. K. Brummelkamp, S. Bouma, M. H. Mensch, F. Kammerurans, et al.,Life without blood: a study of the influence of high atmospheric pressure and hypothermia on dilution of blood, Cardiovasc. Surg. 1, 133–146 (1960).Google Scholar
- 29.E. Braunwald, J. Ross, and E. H. Sonnenblick, Mechanisms of Contraction of the Normal and Failing Heart (Little, Brown and Company, Boston, 1967 ).Google Scholar
- 31.P. C. Swift, J. H. Turner, H. F. Oxer, J. P. O’Shea, G. K. Lane, and K. V. Woollard, Myocardial hibernation identified by hyperbaric oxygen treatment and echocardiography in postinfarction patients: comparison with exercise thallium scintigraphy, Am. Heart J. 124, 1151–1158 (1992).PubMedCrossRefGoogle Scholar