..Reference groupTrauma patients with morphologically and functionally normal lungs who underwent emergency CT were divided into spontaneously breathing (reference spontaneous) and mechanically ventilated http://www.selleckchem.com/products/BAY-73-4506.html (reference ventilated) patients (Figure (Figure11 and Table Table1).1). Patients with pneumothorax, pleural fluid or opacifications other than small, localized dorsal atelectasis were not included. The decision whether a lung was normal was based on the consensus of one radiologist and two intensivists. If data were available, the PaO2/FiO2 ratio had to be greater than 400 mmHg.Table 1Demographic dataaALI groupTrauma patients were eligible for the ALI group if they had undergone CT within 24 hours posttrauma, fulfilled the clinical criteria for ALI (that is, acute onset, typical trigger, absence of heart failure and PaO2/FiO2 ratio below 300 mmHg) at admission and CT showed bilateral pulmonary opacifications (Figure (Figure1)1) [1].

Physiological and demographic data were obtained from the patient data management system into which these data had been prospectively and automatically entered. The ventilator-free days and the intensive care unit (ICU)-free days were calculated as the number of days without mechanical ventilation or ICU treatment, respectively, within a period of 28 days [26]. The Lung Injury Score (LIS), the Injury Severity Score (ISS), the Abbreviated Injury Scale of the Thorax (AIS-T) and the Thoracic Trauma Severity Score (TTSS) were calculated at the time of admission [27-29].

The Glasgow Coma Scale (GCS) score at the trauma scene and the amount of intravenous fluids administered prior to CT were calculated on the basis of the ambulance report form.Pressure-controlled mechanical ventilation (reference ventilated and ALI) during primary resuscitation and CT was standardized and included the following ventilator settings (Oxylog 3000; Dr?ger, L��beck, Germany): target tidal volume of 6 ml/kg estimated body weight (estimated weight in kilograms equals height in centimeters minus 100), respiratory rate of 20 breaths min-1 and positive end-expiratory pressure of 10 cmH2O [21,30].CT scanningEach CT scan was requested by the treating physicians as routine diagnostic procedure in emergency trauma patients [21,31]. Depending on availability, two multislice CT scanners were used, either a Somatom Volume Zoom (120-kV tube voltage, 165-mA tube current, 4 �� 2.

5-mm collimation; Siemens, Erlangen, Germany) or a Philips MX8000 IDT 16 (120-kV tube voltage, 170-mA tube current, 16 �� 1.5-mm collimation; Philips Medical Systems, Hamburg, Dacomitinib Germany). As part of routine clinical imaging, contiguous images were reconstructed with either 10-mm slice thickness and the enhancing filter “B60f” on the Siemens scanner or 5-mm thickness and the standard filter “B” on the Philips scanner.