[Investigation of relationship between prehospital care for traumatic shock and postoperative acute lung injury/acute respiratory distress syndrome].

Objective: To investigate and analyze the correlation and clinical significance of prehospital treatment for traumatic shock and postoperative acute lung injury (ALI)/acute respiratory distress syndrome (ARDS).

Methods: Six hundred cases in the last 10 years were enrolled for double-blind randomized control study. They were divided into 3 groups. Group A consisted of 184 cases who had received combined treatment, group B consisted of 305 cases who had received fluid replacement only and group C consisted of 111 cases with no treatment. The incidence of systemic inflammatory response syndrome (SIRS), ALI and ARDS of each group were analyzed and compared. SIRS was graded at 1 (T0) after admission, 24 (T1), 48 (T2), 96 (T3) and 144 hours (T4) after operation.

Results: In 524 cases diagnosis of SIRS was made among 600 patients (87.33%). Among them 73.37% (135/184 cases) were in group A, 91.48% (279/305 cases) belonged to group B and 99.10% (110/111 cases) in group C. The scores of SIRS were notably lower in group A than B and C at each time point (all P<0.01), and they were lower in group B than those in group C (all P<0.01), they recovered at T3 after operation in group A while in group B patients recovered at 144 hours after operation. Eleven patients among 184 (5.98%) were diagnosed to have ALI including 1 case progressed to ARDS and 1 case to MODS and no one died, while in group B 32 cases in 305 (10.49%) had ALI with 7 cases progressed to ARDS and 3 cases to MODS while 3 deaths and in group C 23 among 111 (20.72%) had ALI, and 8 patients progressed to ARDS, 5 cases to MODS and 5 deaths.

Conclusion: Prehospital treatment is closely related with postoperative ALI, and combined treatment is beneficial in reducing the incidence of postoperative ALI/ARDS.