Adult Respiratory Distress Syndrome: An Aspect of Multiple by J. A. Sturm (auth.), Professor Dr. J. A. Sturm (eds.)

By J. A. Sturm (auth.), Professor Dr. J. A. Sturm (eds.)

l. A. STURM In sleek society, trauma is still the number 1 explanation for loss of life in humans less than 50 years, yet, regardless of this, little or no awareness has been paid to trauma care in comparison with different illnesses resembling malignancy or myocardial infarction (Table 1). The efforts which have been made in remedy, notwithstanding, have confirmed a few good fortune; for instance even supposing the frequency of site visitors injuries within the Federal Republic of Germany has remained consistent through the years, the variety of deaths caused by them has lowered (Fig. 1). the result of advancements in rescue platforms, surgical recommendations, and in depth care are obtrusive, as proven through a overview of the information of approximately 3000 a number of trauma sufferers taken care of within the final 15 years on the trauma de­ partment of Hannover clinical university which displays the development that has been made in remedy. After the matter posed by way of posttraumatic kidney failure were solved within the Nineteen Sixties and Seventies, the grownup respiration misery syndrome (ARDS) turned the largest challenge within the Nineteen Seventies and Eighties (Fig. 2). ARDS as a unmarried entity disappeared within the literature within the early Nineteen Eighties and was once changed via the so-called a number of organ failure (MOF) syndrome. among 1985 and 1990 35% of the sufferers in our in depth care unit built MOF, and 70% of them died. total MOF mortality has remained consistent considering the fact that 1985 at approximately 20% (Fig. 3).

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Monocytes and lymphocytes showed an uncharacteristic course after trauma. Platelets were decreased significantly in the ARDS group over almost the whole study period from the 6th h after trauma. From the 12th h, the platelet count of the ARDS group fell below the threshold of 100000 platelets/mm3 . There was minimal variation in the values between the 12th h and 9th day for the ARDS group. 0 normal values of 400 000/mm 3 , with little variation (Fig. 9). The hemoglobin levels in the ARDS group initially showed a highly significant difference.

Severity of injury of more than 30 points on the Poly trauma Score (PTS) [14] 2. Age, 15-65 years 3. Prehospital therapy-free interval less than 60 min Department of Trauma Surgery, Hannover Medical School, Kanstanty-Gutschow-Str. A. ) Adult Respiratory Distress Syndrome © Springer-Verlag Berlin Heidelberg 1991 46 4. 5. 6. 7. L. Nerlich Accident-admission time less than 120min Glasgow-Coma Scale (GCS) more than 8 points No steroids, colloids, or protease inhibitors Constant and uniform therapeutic regimen in the intensive care unit.

2 Fig. 3. Correlation between ARDS score and severity of pulmonary failure in the Essen group Considering the first two questions we were able to demonstrate that the model had sufficient stability: No more than four. patients were classified differently by ARDS/MPD using the scoring system with a smaller number of patients or shorter periods (2::48 h) for the observation. For the third question we tested the model with the group of patients from Hannover. 76 (Fig. 4). Conclusions The score is valid because it is based only on criteria for the definition of ARDS, and thus a classification of patients with ARDS/MPD based on objective measurable parameters is possible.

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