Abstract
Background Our purpose was to summarise the prognostic associations between various clinical risk factors and development of acute respiratory distress syndrome (ARDS) following traumatic injury.
Methods We conducted this review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies) guidelines. We searched six databases from inception through December 2020. We included English language studies describing the clinical risk factors associated with development of post-traumatic ARDS, as defined by either the American–European Consensus Conference or Berlin definition. We pooled adjusted odds ratios for prognostic factors using the random effects method. We assessed risk of bias using the QUIPS (Quality in Prognosis Studies) tool and certainty of findings using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology.
Results We included 39 studies involving 5 350 927 patients. We identified the amount of crystalloid resuscitation as a potentially modifiable prognostic factor associated with development of post-traumatic ARDS (adjusted OR 1.19, 95% CI 1.15–1.24 for each additional litre of crystalloid administered within the first 6 h after injury; high certainty). Non-modifiable prognostic factors with a moderate or high certainty of association with post-traumatic ARDS included increasing age, non-Hispanic White race, blunt mechanism of injury, presence of head injury, pulmonary contusion or rib fracture and increasing chest injury severity.
Conclusions We identified one important modifiable factor, the amount of crystalloid resuscitation within the first 24 h of injury, and several non-modifiable factors associated with development of post-traumatic ARDS. This information should support the judicious use of crystalloid resuscitation in trauma patients and may inform development of risk stratification tools.
Abstract
This systematic review identifies one important modifiable factor, the amount of crystalloid resuscitation within the first 24 h of injury, and several non-modifiable factors associated with development of post-traumatic ARDS https://bit.ly/3klhshF
Footnotes
Author contributions: A. Tran, S.M. Fernando and B. Rrochwerg conceived the study idea. All authors participated in the creation of the study protocol. A. Tran and S.M. Fernando completed the search, screening and extraction. A. Tran, S.M. Fernando and B. Rrochwerg completed the data analysis. All authors participated in the creation and review of the manuscript. All authors approved the final manuscript draft.
This article has supplementary material available from erj.ersjournals.com
Conflict of interest: A. Tran has nothing to disclose.
Conflict of interest: S.M. Fernando has nothing to disclose.
Conflict of interest: L.J. Brochard has nothing to disclose.
Conflict of interest: E. Fan reports receiving personal fees from ALung Technologies, Baxter, Fresenius Medical Care, Getinge and MC3 Cardiopulmonary, outside of the submitted work.
Conflict of interest: K. Inaba has nothing to disclose.
Conflict of interest: N.D. Ferguson has nothing to disclose.
Conflict of interest. C. Calfee receives grant funding from the NIH (related) as well as Roche-Genentech and Quantum Leap Healthcare Collaborative, outside of the submitted work; she has served as a medical advisor to Roche-Genentech, Bayer, CSL Behring, Quark Pharmaceuticals, Vasomune and Gen1e Life Sciences, outside of the submitted work.
Conflict of interest: C.S. Calfee has nothing to disclose. K.E.A. Burns is supported by a Physician Services Incorporated-50 Mid-Career Clinical Research Award.
Conflict of interest: D. Brodie reports receiving research support from ALung Technologies, outside of the submitted work, and was previously on their medical advisory board; he has been on the medical advisory boards for Baxter, Abiomed, Xenios AG and Hemovent.
Conflict of interest: V.A. McCredie has nothing to disclose.
Conflict of interest: D.Y. Kim has nothing to disclose.
Conflict of interest: K. Kyeremanteng has nothing to disclose.
Conflict of interest: J. Lampron has nothing to disclose.
Conflict of interest: A.S. Slutsky reports consulting for Baxter and Xenios AG.
Conflict of interest: A. Combes reports receiving personal fees from Maquet, Xenios AG and Baxter International Inc., outside of the submitted work.
Conflict of interest: B. Rochwerg is supported by a Hamilton Health Sciences New Investigator Grant.
- Received March 23, 2021.
- Accepted August 17, 2021.
- Copyright ©The authors 2022. For reproduction rights and permissions contact permissions{at}ersnet.org
LIBRARY USERS
Log in through your institution
Purchase access
