ARDS complicated by severe thoracic injury in 30 cases

Objective To investigate diagnosis and treatment of acute respiratory distress syndrome (ARDS) complicated by thoracic injury. Methods Thirty patients with severe thoracic injury complicated with ARDS were studied retrospectively, and their ABG, PaO 2/FiO 2 and Qs/Qt were analyzed to show the relationship of different treatment and the disease severity. Results In this group, ARDS accounted for 9.8% in thoracic injury, 41.1% in severe thoracic trauma. The initial PaO 2 of the patients was (6.51±0.97) kPa, PaCO 2 (4.64±1.09) kPa, PaO 2/FiO 2 (12.11±2.99) kPa, Qs/Qt (24.72±8.93)%. All the patients required mechanical ventilation (mean= 6.8 days) and 21 cases required tracheotomy. The mortality was 13.3%. The incidence of pneumonia was 43.3%. Among the survival patients, the mean length of hospital stay was 34.2 d. Conclusions Early diagnosis and treatment of ARDS, correct application of mechanical ventilation and correct treatment of multiple injuries and shock are effective methods to decrease mortality of ARDS. Meanwhile, the patients should be monitored intensively. In addition, reasonable application of antibiotics is also important.