Specific coagulation and fibrinolysis tests as biochemical markers in traumatic-induced adult respiratory distress syndrome.

There is a great demand for more specific methods for assaying individual components of coagulation and fibrinolysis, with the chief aim being to use them as biochemical markers of the Adult Respiratory Distress Syndrome (ARDS) induced by severe trauma. This prospective study was undertaken on 18 severely traumatized patients in various stages of shock admitted to the Intensive Care Unit of the University Hospital in Uppsala, Sweden. After haemodynamic restitution, during which surgery was often required as an intervening procedure, the patients were carefully studied regarding pulmonary function, coagulation and fibrinolysis. Eight patients developed ARDS according to our criteria, and one patient died from this condition. It was found that patients who developed ARDS had significantly lower levels of antithrombin-III, higher levels of von Willebrand factor levels, higher levels of tissue plasminogen activator inhibitors and lower levels of plasminogen as compared with those who did not develop this condition. We believe that these coagulation and fibrinolysis variables can be used along with appropriate pulmonary function tests as specific biochemical markers to disclose the development of traumatic-induced ARDS.