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Optimal ventilator strategies for trauma-related ARDS
  1. Giles Goatly1,
  2. N Guidozzi2 and
  3. M Khan2
  1. 1Department of Surgery, Imperial College Healthcare NHS Trust, London, UK
  2. 2Department of Surgery, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to M Khan, St Mary’s Hospital, Consultant Trauma Surgeon, Imperial College Healthcare NHS Trust, London, UK; mansoorkhan{at}nhs.net

Abstract

Background Acute respiratory distress syndrome (ARDS) was first described in the 1960s and has become a major area of research due to the mortality and morbidity associated with it. ARDS is currently defined using the Berlin Consensus; however, this is not wholly applicable for trauma-related ARDS.

Methods A systematic review of the literature was undertaken using the Preferred Reporting for Systematic Reviews and Meta Analyses methodology. The Ovid Medline, Web of Science and PubMed online databases were interrogated for papers published between 1 January 1995 and 31 December 2017.

Results The literature search yielded a total of 64 papers that fulfilled the search criteria.

Conclusions Despite decades of dedicated research into different treatment modalities, ARDS continues to carry a high burden of mortality. The ARDS definitions laid out in the Berlin consensus are not entirely suited to trauma. While trauma-related ARDS represents a small portion of the available research, the evidence continues to favour low tidal volume ventilation as the benchmark for current practice. Positive end expiratory ventilation and airway pressure release ventilation in trauma cohorts may be beneficial; however, the evidence to date does not show this.

  • respiratory physiology
  • trauma management
  • acute respiratory distress syndrome

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Footnotes

  • Contributors GG performed literature search and first draft. NG corroborated literature search and provided revisions. MK reviewed each draft providing alterations.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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