Late sequaela of primary post-traumatic ARDS

Introduction

Post-traumatic lung injuries with consecutive ALI and ARDS are frequent injuries in trauma populations. There is only a small body of literature dealing with late sequaela of ALI and ARDS. To evaluate the long-term disability and disorders of lung function in these patients, we initiated a prospective, nonrandomised study.

Patients and methods

The study population was recruited from a group of 111 patients from a former study dealing with position therapy for the treatment of acute lung injuries. Patients were included if they survived the initial injuries and were avaliable for pulmonary function testing and had a minimal followup of 1 year. In all included patients the pulmonary function were tested in the laboratory with a bodyplethysmograph from Jaeger (Wuerzburg, Germany). The bellows function included vital capacity (VC [l]) and forced expiratory volume in 1 s (FEV1 [l]). In addition, blood samples for the calculation of capillary blood oxygenation were collected. The pO₂/FiO₂ rational was calculated. The respiratory data were compared with a control group from historical literature-based data including 49 patients. n = 19 patients were avaliable for physical evaluation.

Statistics

The initial ISS of the population was 40 (15–59), age 40.5 years (19–71), the initial paO₂/FiO₂ was 286 (95–466). Time on the respirator was 14.3 days (3–31).

Results

The results of the laboratory examination are presented in Table 1.

Table 1

Discussion

The presented study demonstrates a moderate reduction in respiratory function (VC, FEV1) 1 year after severe chest injury. Our pulmonary outcome data could not demonstrate a significant difference to the historical control group. Blood gas analysis and cardiopulmonary function were normal with the exception of one case. In conclusion, we postulate that severe injury to the chest leads to a moderate decrease of pulmonary function in polytrauma patients with ALI and ARDS.