Post Traumatic Acute Respiratory Distress Syndrome in the Emergency and Critical Care Units of the Douala General Hospital Cameroon

Introduction: Acute Respiratory Distress Syndrome (ARDS) is a severe, life-threatening complication of major traumatic injury, contributing significantly to morbidity and mortality in emergency and critical care settings globally. Data on the specific clinical profile and outcomes in Sub-Saharan African trauma centers are scarce. Objective: The Objective was to describe the epidemiology, clinical profile, severity of injury (Injury Severity Score, ISS), surgical management, and therapeutic outcomes of post-traumatic ARDS among adult trauma patients managed at the Emergency and Critical Care Unit (ECCU) of Douala General Hospital (DGH). Materials and methods: the method was a retrospective observational study was conducted over a 24 months period (January 2022 to December 2024) at DGH, including 68 consecutive adult trauma patients who developed ARDS based on the Berlin criteria. Data collected included demographics, mechanism of injury, ISS, associated injuries (especially Thoracic Trauma and Traumatic Brain Injury [TBI]), ASA physical status, intra-operative events, ARDS severity, and final outcomes (survival vs. death). Results: The mean age was 39.8±14.7 years, with a male predominance (79.4%). Severe trauma (ISS ≥25) accounted for 79.4% of the cohort, with a mean ISS of 31.6±11.2. The most frequent injuries were Thoracic Trauma (50.0%) and Long Bone Fractures (42.6%). Early complications included shock (44.1%) and massive hemorrhage (36.8%). Urgent surgeries were performed in 67.6% of operative cases. ARDS onset occurred at a median of 2.8 days post-injury. The overall in-hospital mortality was 32.4%. Independent predictors of mortality included ISS≥35, the presence of shock on admission, and severe TBI. Therefore, post-traumatic ARDS represents a major burden in the DGH ECCU, driven by high-velocity blunt trauma and associated with a significant mortality rate of 32.4%. Conclusion: These findings emphasize the necessity of strict, multidisciplinary protocols focused on prompt hemorrhage control, optimized resuscitation, and early identification of high-risk trauma patterns to improve critical care outcomes.