Broderick Joseph C, Mancha Fabiola, Long Brit J, Maddry Joseph K, Chung Kevin K, Schauer Steven G
Brooke Army Medical Center, JBSA Fort Sam Houston, San Antonio, TX.
US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, TX.
Crit Care Explor. 2022 Sep 14;4(9):e0759. doi: 10.1097/CCE.0000000000000759. eCollection 2022 Sep.
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.
Pubmed was searched from 1969 to April 2022.
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).
Study years, design, location, number of patients, target outcomes as related to ALI/ARDS or related entities, and results were collected.
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.
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.
急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS）是战斗伤员受伤后已知的并发症，但尚未有综述对其进行描述。本范围综述旨在梳理与战斗创伤相关的ALI/ARDS文献，并描述军事人群中的这些病症。
检索了1969年至2022年4月的PubMed。
纳入的研究需考察军事人员（美国或盟军）战斗创伤患者中的ALI/ARDS或相关实体（爆震性肺损伤[BLI]、输血相关急性肺损伤和急性呼吸衰竭）。
收集研究年份、设计、地点、患者数量、与ALI/ARDS或相关实体相关的目标结局以及结果。
初步检索产生442项研究，最终纳入22项。关于ALI/ARDS的文献大多来自回顾性数据和病例研究，前瞻性研究有限。ALI/ARDS的发病率和患病率在3%至33%之间，死亡率在12.8%至33%之间。BLI是ALI/ARDS的已知前驱病症，其发病率和死亡率分别在1.4%至40%和11%至56%之间。ALI/ARDS的危险因素包括肺部损伤、吸入性损伤、钝性创伤、肺炎、更高的军事损伤严重程度评分、更高的损伤严重程度评分、更高的新鲜冰冻血浆量、更高的血浆和血小板量、使用温热的新鲜全血、女性、低血压和心动过速。文献已证明转运这些患者的有效性以及体外生命支持的效用。
现代冲突中ALI/ARDS的发病率和患病率在3%至33%之间，死亡率在12.8%至33%之间。ALI/ARDS与损伤严重程度指标、损伤类型、复苏液体量和类型、生命体征以及患者人口统计学特征有关。研究大多限于回顾性数据，需要更多数据来更好地描述这些病症。
