• Penny L Andrews, Joseph R Shiber, Ewa Jaruga-Killeen, Shreyas Roy, Benjamin Sadowitz, Robert V O'Toole, Louis A Gatto, Gary F Nieman, Thomas Scalea, and Nader M Habashi.
• From the R Adams Cowley Shock Trauma Center (P.L.A., T.S., N.M.H.); and Department of Orthopaedics (R.V.O.), University of Maryland School of Medicine, Baltimore Maryland; University of Florida College of Medicine (J.R.S.), Jacksonville; and Orlando Health MERTC (E.J.-K.), Orlando, Florida; Upstate Medical University (S.R., B.S., G.F.N.), Syracuse; and SUNY Cortland (L.A.G.), Cortland, New York.
• J Trauma Acute Care Surg. 2013 Oct 1;75(4):635-41.

BackgroundAdult respiratory distress syndrome is often refractory to treatment and develops after entering the health care system. This suggests an opportunity to prevent this syndrome before it develops. The objective of this study was to demonstrate that early application of airway pressure release ventilation in high-risk trauma patients reduces hospital mortality as compared with similarly injured patients on conventional ventilation.MethodsSystematic review of observational data in patients who received conventional ventilation in other trauma centers were compared with patients treated with early airway pressure release ventilation in our trauma center. Relevant studies were identified in a PubMed and MEDLINE search from 1995 to 2012 and included prospective and retrospective observational and cohort studies enrolling 100 or more adult trauma patients with reported adult respiratory distress syndrome incidence and mortality data.ResultsEarly airway pressure release ventilation as compared with the other trauma centers represented lower mean adult respiratory distress syndrome incidence (14.0% vs. 1.3%) and in-hospital mortality (14.1% vs. 3.9%).ConclusionThese data suggest that early airway pressure release ventilation may prevent progression of acute lung injury in high-risk trauma patients, reducing trauma-related adult respiratory distress syndrome mortality.Level Of EvidenceSystematic review, level IV.

14 keywords...

hide…