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Of people with pulmonary contusion alone, 17% develop ARDS, while 78% of people with at least two additional injuries develop the condition. [6] A larger contusion is associated with an increased risk. In one study, 82% of people with 20% or more of the lung volume affected developed ARDS, while only 22% of people with less than 20% did so. [7]
2 ratio indicates reduced arterial oxygenation from the available inhaled gas): mild ARDS: 201 – 300 mmHg (≤ 39.9 kPa) moderate ARDS: 101 – 200 mmHg (≤ 26.6 kPa) severe ARDS: ≤ 100 mmHg (≤ 13.3 kPa) The Berlin definition requires a minimum positive end expiratory pressure (PEEP) of 5 cm H 2 O for consideration of the Pa O 2 /Fi O 2 ...
VALI is most common in people receiving mechanical ventilation for acute lung injury or acute respiratory distress syndrome (ALI/ARDS). [1] 24 percent of people mechanically ventilated will develop VALI for reasons other than ALI or ARDS. [1] The incidence is probably higher among people who already have ALI/ARDS, but estimates vary widely. [1]
The pathophysiology of acute respiratory distress syndrome involves fluid accumulation in the lungs not explained by heart failure (noncardiogenic pulmonary edema). It is typically provoked by an acute injury to the lungs that results in flooding of the lungs' microscopic air sacs responsible for the exchange of gases such as oxygen and carbon dioxide with capillaries in the lungs. [1]
Flail chest is usually accompanied by a pulmonary contusion, a bruise of the lung tissue that can interfere with blood oxygenation. [5] Often, it is the contusion, not the flail segment, that is the main cause of respiratory problems in people with both injuries. [6] Surgery to fix the fractures appears to result in better outcomes. [7]
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It has been revealed that patients with ARDS that show DAD on histology are at a high mortality rate of 71.9% compared to 45.5% in patients with ARDS but without DAD. [12] Of the patients who succumb to ARDS, the most common cause of death is septic shock with multi organ dysfunction syndrome. [13]
Typically chest injuries are caused by blunt mechanisms such as direct, indirect, compression, contusion, deceleration, or blasts [2] caused by motor vehicle collisions or penetrating mechanisms such as stabbings. [3]