J Natl Med Assoc
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Sixteen trauma victims with adult respiratory distress syndrome were retrospectively examined. High injury severity score (mean: 44), massive transfusion requirements, and prolonged ventilator days characterize this group. Persistent intra-abdominal infection accounted for two of three deaths in this series. ⋯ High frequency jet ventilation was necessary in one subject. Two patients exhibited early ARDS reversal, ie, clinical improvement, better chest x-ray and decreased shunt (within 72 hours) when an intra-abdominal septic focus was eradicated. Principles of critical care for these patients remain: an FiO2 less than .40, limiting barotrauma, using PEEP for alveolar recruitment and close monitoring of O2 transport.