TY - JOUR
T1 - Combat Trauma-Related Acute Respiratory Distress Syndrome
T2 - A Scoping Review
AU - Broderick, Joseph C.
AU - Mancha, Fabiola
AU - Long, Brit J.
AU - Maddry, Joseph K.
AU - Chung, Kevin K.
AU - Schauer, Steven G.
N1 - Publisher Copyright:
© 2022 Wolters Kluwer Health. All rights reserved.
PY - 2022/9/14
Y1 - 2022/9/14
N2 - OBJECTIVE: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are known complications of injuries in combat casualties, but there has been no review characterizing them. This scoping review aims to map the combat trauma-related ALI/ARDS literature and characterize these conditions in the military population. DATA SOURCES: Pubmed was searched from 1969 to April 2022. STUDY SELECTION: Studies were included if they examined ALI/ARDS or related entities (blast lung injury [BLI], transfusion-related acute lung injury, and acute respiratory failure) in combat trauma patients in the military (U.S. or allied forces). DATA EXTRACTION: Study years, design, location, number of patients, target outcomes as related to ALI/ARDS or related entities, and results were collected. DATA SYNTHESIS: The initial search yielded 442 studies, with 22 ultimately included. Literature on ALI/ARDS comes mostly from retrospective data and case studies, with limited prospective studies. The incidence and prevalence of ALI/ARDS range from 3% to 33%, and mortality 12.8% to 33%. BLI, a known antecedent to ALI/ARDS, has an incidence and mortality ranging from 1.4% to 40% and 11% to 56%, respectively. Risk factors for ALI/ARDS include pulmonary injury, inhalation injury, blunt trauma, pneumonia, higher military injury severity score, higher injury severity score, higher fresh frozen plasma volumes, higher plasma and platelet volumes, the use of warm fresh whole blood, female sex, low blood pressure, and tachycardia. Literature has demonstrated the effectiveness in transportation of these patients and the utility of extracorporeal life support. CONCLUSIONS: ALI/ARDS incidences and prevalences in modern conflict range from 3% to 33%, with mortality ranging from 12.8% to 33%. ALI/ARDS has been associated with injury severity metrics, injury type, resuscitative fluid amount and type, vital signs, and patient demographics. Studies are limited to mostly retrospective data, and more data are needed to better characterize these conditions.
AB - OBJECTIVE: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are known complications of injuries in combat casualties, but there has been no review characterizing them. This scoping review aims to map the combat trauma-related ALI/ARDS literature and characterize these conditions in the military population. DATA SOURCES: Pubmed was searched from 1969 to April 2022. STUDY SELECTION: Studies were included if they examined ALI/ARDS or related entities (blast lung injury [BLI], transfusion-related acute lung injury, and acute respiratory failure) in combat trauma patients in the military (U.S. or allied forces). DATA EXTRACTION: Study years, design, location, number of patients, target outcomes as related to ALI/ARDS or related entities, and results were collected. DATA SYNTHESIS: The initial search yielded 442 studies, with 22 ultimately included. Literature on ALI/ARDS comes mostly from retrospective data and case studies, with limited prospective studies. The incidence and prevalence of ALI/ARDS range from 3% to 33%, and mortality 12.8% to 33%. BLI, a known antecedent to ALI/ARDS, has an incidence and mortality ranging from 1.4% to 40% and 11% to 56%, respectively. Risk factors for ALI/ARDS include pulmonary injury, inhalation injury, blunt trauma, pneumonia, higher military injury severity score, higher injury severity score, higher fresh frozen plasma volumes, higher plasma and platelet volumes, the use of warm fresh whole blood, female sex, low blood pressure, and tachycardia. Literature has demonstrated the effectiveness in transportation of these patients and the utility of extracorporeal life support. CONCLUSIONS: ALI/ARDS incidences and prevalences in modern conflict range from 3% to 33%, with mortality ranging from 12.8% to 33%. ALI/ARDS has been associated with injury severity metrics, injury type, resuscitative fluid amount and type, vital signs, and patient demographics. Studies are limited to mostly retrospective data, and more data are needed to better characterize these conditions.
KW - acute lung injury
KW - critical care
KW - lung injury
KW - military personnel
KW - respiratory distress syndrome
UR - http://www.scopus.com/inward/record.url?scp=85139432016&partnerID=8YFLogxK
U2 - 10.1097/CCE.0000000000000759
DO - 10.1097/CCE.0000000000000759
M3 - Review article
AN - SCOPUS:85139432016
SN - 2639-8028
VL - 4
SP - E0759
JO - Critical Care Explorations
JF - Critical Care Explorations
IS - 9
ER -