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Module 3: The Body's Response to Injury

Segment 4: Ventilation & Diffusion

References labeled PEDS contain a pediatric element or primary focus.

Topic: Ventilation

  • Boon Y, Kuan WS, Chan YH, et al. Agreement between arterial and venous blood gases in trauma resuscitation in emergency department (AGREE). Eur J Trauma Emerg Surg. 2021;47(2):365-372. doi: 10.1007/s00068-019-01190-6 https://pubmed.ncbi.nlm.nih.gov/31321471/.
  • Bryant MK, Portelli Tremont JN, Patel Z, et al. Low initial pre-hospital end-tidal carbon dioxide predicts inferior clinical outcomes in trauma patients. Injury. 2021;52(9):2502-2507. doi: 10.1016/j.injury.2021.07.019 https://pubmed.ncbi.nlm.nih.gov/34289938/.
  • Byrne AL, Bennett M, Chatterji R, et al. Peripheral venous and arterial blood gas analysis in adults: are they comparable? A systematic review and meta-analysis. Respirology. 2014;19(2):168-175. doi: 10.1111/resp.12225 https://pubmed.ncbi.nlm.nih.gov/24383789/.
  • Camarda A, Gibson J, Coffey S, et al. ENA clinical practice guideline synopsis: The use of capnography during procedural sedation/analgesia. J Emerg Nurs. 2025;51(2):211-214. doi: 10.1016/j.jen.2024.10.014 https://pubmed.ncbi.nlm.nih.gov/40049782/.
  • Campion EM, Cralley A, Sauaia A, et al. Prehospital end-tidal carbon dioxide is predictive of death and massive transfusion in injured patients: An Eastern Association for Surgery of Trauma multicenter trial. J Trauma Acute Care Surg. 2022;92(2):355-361. doi: 10.1097/ta.0000000000003447 https://pubmed.ncbi.nlm.nih.gov/34686640/.
  • Davis JA, Manoach S, Heerdt P, et al. Management of respiratory failure in hemorrhagic shock. Ann Am Thorac Soc. 2024;21(7):993-997. doi: 10.1513/AnnalsATS.202310-905CME https://pubmed.ncbi.nlm.nih.gov/38669620/.
  • DeMasi SC, Casey JD, Semler MW. Evidence-based emergency tracheal intubation. Am J Respir Crit Care Med. 2025;doi: 10.1164/rccm.202411-2165CI https://pubmed.ncbi.nlm.nih.gov/40238943/.
  • Epstein D, Goldman S, Radomislensky I, et al. Airway management in trauma patients with active hemorrhage: Does intubation location matter? A nationwide retrospective cohort study. Am J Emerg Med. 2025;96:41-47. doi: 10.1016/j.ajem.2025.06.023 https://pubmed.ncbi.nlm.nih.gov/40517708/.
  • Eskesen TG, Baekgaard JS, Steinmetz J, et al. Initial use of supplementary oxygen for trauma patients: a systematic review. BMJ Open. 2018;8(7):e020880. doi: 10.1136/bmjopen-2017-020880 https://pubmed.ncbi.nlm.nih.gov/29982208/.
  • Eugene V, Hutzler J, Kempema J, et al. The difficult airway in trauma: What you need to know. J Trauma Acute Care Surg. 2024;97(5):661-669. doi: 10.1097/ta.0000000000004402 https://pubmed.ncbi.nlm.nih.gov/38775709/.
  • Fischer CP, Bilimoria KY, Ghaferi AA. Rapid response teams as a patient safety practice for failure to rescue. JAMA. 2021;doi: 10.1001/jama.2021.7510 https://pubmed.ncbi.nlm.nih.gov/34165513/.
  • Gavelli F, Teboul JL, Monnet X. How can CO2-derived indices guide resuscitation in critically ill patients? J Thorac Dis. 2019;11(Suppl 11):S1528-s1537. doi: 10.21037/jtd.2019.07.10 https://pubmed.ncbi.nlm.nih.gov/31388457/.
  • Giani D, Santoro MC, Gabrielli M, et al. The role of venous blood gas analysis in critical care: A narrative review. Medicina (Kaunas). 2025;61(8) doi: 10.3390/medicina61081337 https://pubmed.ncbi.nlm.nih.gov/40870384/.
  • Hellings SD, Fuller J, Maillie S. End-tidal CO2 monitoring. Am Nurse J. 2024;2024(September):6-12. doi:  https://www.myamericannurse.com/end-tidal-co2-monitoring/#:~:text=End%2Dtidal%20carbon%20dioxide%20(ETCO,2%20via%20the%20respiratory%20system).
  • Hunter CL, Silvestri S, Dean M, et al. End-tidal carbon dioxide is associated with mortality and lactate in patients with suspected sepsis. Am J Emerg Med. 2013;31(1):64-71. doi: 10.1016/j.ajem.2012.05.034 https://pubmed.ncbi.nlm.nih.gov/22867820/.
  • Lacy ME, Saa L, Bruss Z, et al. Things We Do for No Reason™: Arterial blood gas testing to screen for hypercarbic respiratory failure. J Hosp Med. 2025;20(9):1002-1004. doi: 10.1002/jhm.70039 https://pubmed.ncbi.nlm.nih.gov/40183604/.
  • Ladde JG, Miller S, Chin K, et al. End-tidal carbon dioxide measured at emergency department triage outperforms standard triage vital signs in predicting in-hospital mortality and ICU admission. Acad Emerg Med. 2023;doi: 10.1111/acem.14703 https://pubmed.ncbi.nlm.nih.gov/36802204/.
  • Maia IWA, Besen B, Silva L, et al. Peri-intubation adverse events and clinical outcomes in emergency department patients: the BARCO study. Crit Care. 2025;29(1):155. doi: 10.1186/s13054-025-05392-w https://pubmed.ncbi.nlm.nih.gov/40247381/.
  • Peyton PJ, Wallin M, Hallback M. New generation continuous cardiac output monitoring from carbon dioxide elimination. BMC Anesthesiol. 2019;19(1):28. doi: 10.1186/s12871-019-0699-5 https://pubmed.ncbi.nlm.nih.gov/30808309/.
  • Portelli Tremont JN, Caldas RA, Cook N, et al. Low initial in-hospital end-tidal carbon dioxide predicts poor patient outcomes and is a useful trauma bay adjunct. Am J Emerg Med. 2022;56:45-50. doi: 10.1016/j.ajem.2022.03.034 https://pubmed.ncbi.nlm.nih.gov/35364477/.
  • Rengasamy S, Nassef B, Bilotta F, et al. Administration of supplemental oxygen. N Engl J Med. 2021;385(3):e9. doi: 10.1056/NEJMvcm2035240 https://pubmed.ncbi.nlm.nih.gov/34260838/.
  • Rodriguez KA, Tran QK, Ali M, et al. End-tidal carbon dioxide as a predictor of mortality in trauma patients: A systematic review and meta-analysis. J Trauma Acute Care Surg. 2026;doi: 10.1097/ta.0000000000004968 https://pubmed.ncbi.nlm.nih.gov/41879772/.
  • Semler MW, Casey JD, Lloyd BD, et al. Oxygen-saturation targets for critically ill adults receiving mechanical ventilation. N Engl J Med. 2022;387(19):1759-1769. doi: 10.1056/NEJMoa2208415 https://pubmed.ncbi.nlm.nih.gov/36278971/.
  • Talmy T, Radomislensky I, Brzezinski Sinai I, et al. Intubation setting and mortality in trauma patients undergoing hemorrhage control surgery: A propensity score-matched analysis. Anesth Analg. 2025;doi: 10.1213/ane.0000000000007542 https://pubmed.ncbi.nlm.nih.gov/40378073/.
  • Taniguchi H, Utsumi S, Kajiyama T, et al. Noninvasive respiratory support strategies in chest trauma: A systematic review and network meta-analysis. J Trauma Acute Care Surg. 2026;101(2):340-347. doi: 10.1097/ta.0000000000004987 https://pubmed.ncbi.nlm.nih.gov/41989256/.
  • Walston JM, Cabrera D, Bellew SD, et al. Vital signs predict rapid-response team activation within twelve hours of emergency department admission. West J Emerg Med. 2016;17(3):324-30. doi: 10.5811/westjem.2016.2.28501 https://pubmed.ncbi.nlm.nih.gov/27330665/.
  • Wang P, Huang Q, Liu B, et al. Oxygen therapy in the intensive care unit. Med Gas Res. 2025;15(4):478-487. doi: 10.4103/mgr.MEDGASRES-D-24-00143 https://pubmed.ncbi.nlm.nih.gov/40300883/.

Topic: Diffusion

  • Al-Husinat L, Azzam S, Al Sharie S, et al. A narrative review on the future of ARDS: evolving definitions, pathophysiology, and tailored management. Crit Care. 2025;29(1):88. doi: 10.1186/s13054-025-05291-0 http://pubmed.ncbi.nlm.nih.gov/39994815/.
  • Arleth T, Baekgaard J, Siersma V, et al. Early restrictive vs liberal oxygen for trauma patients: The TRAUMOX2 randomized clinical trial. JAMA. 2024;doi: 10.1001/jama.2024.25786 https://pubmed.ncbi.nlm.nih.gov/39657224/.
  • Bilan N, Dastranji A, Ghalehgolab Behbahani A. Comparison of the SpO2/FIO2 ratio and the PaO2/FIO2 ratio in patients with acute lung injury or acute respiratory distress syndrome. J Cardiovasc Thorac Res. 2015;7(1):28-31. doi: 10.15171/jcvtr.2014.06 https://pubmed.ncbi.nlm.nih.gov/25859313/.
  • Biuzzi C, Modica E, De Filippis N, et al. Old and new definitions of acute respiratory distress syndrome (ARDS): An overview of practical considerations and clinical implications. Diagnostics (Basel). 2025;15(15) doi: 10.3390/diagnostics15151930 https://pubmed.ncbi.nlm.nih.gov/40804893/.
  • Carlino MV, Guarino M, Izzo A, et al. Arterial blood gas analysis utility in predicting lung injury in blunt chest trauma. Respir Physiol Neurobiol. 2020;274:103363. doi: 10.1016/j.resp.2019.103363 https://pubmed.ncbi.nlm.nih.gov/31866500/.
  • Chaudhuri D, Lazarte J, Shah K, et al. Approaches to converting SpO₂/FIO₂ ratio to PaO₂/FIO₂ ratio for assessment of respiratory failure in critically ill patients: A systematic review. Crit Care Med. 2026;doi: 10.1097/ccm.0000000000007018 https://pubmed.ncbi.nlm.nih.gov/41493393/.
  • Coppola S, Pozzi T, Catozzi G, et al. Clinical performance of SpO₂/FiO₂ and PaO₂/FiO₂ ratios in mechanically ventilated acute respiratory distress syndrome patients: A retrospective study. Crit Care Med. 2025;53(4):e953-62. doi: 10.1097/ccm.0000000000006623 https://pubmed.ncbi.nlm.nih.gov/40029117/.
  • Dahms K, Ansems K, Dormann J, et al. Effectiveness of antibiotic prophylaxis in polytrauma patients: a systematic review and meta-analysis. Eur J Trauma Emerg Surg. 2025;51(1):105. doi: 10.1007/s00068-025-02789-8 https://pubmed.ncbi.nlm.nih.gov/39945862/.
  • Frat JP, Quenot JP, Guitton C, et al. High-flow or standard oxygen in acute hypoxemic respiratory failure. N Engl J Med. 2026;394(21):2095-2106. doi: 10.1056/NEJMoa2516087 https://pubmed.ncbi.nlm.nih.gov/41841715/.
  • Freeman H, Vranas KC, Tuthill S, et al. High-flow nasal cannula liberation: Who, when, and how? Chest. 2025;doi: 10.1016/j.chest.2025.01.037 https://pubmed.ncbi.nlm.nih.gov/39929280/.
  • Giani D, Santoro MC, Gabrielli M, et al. The role of venous blood gas analysis in critical care: A narrative review. Medicina (Kaunas). 2025;61(8) doi: 10.3390/medicina61081337 https://pubmed.ncbi.nlm.nih.gov/40870384/.
  • Grasselli G, Calfee CS, Camporota L, et al. ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping and respiratory support strategies. Intensive Care Med. 2023;49(7):727-759. doi: 10.1007/s00134-023-07050-7 https://pubmed.ncbi.nlm.nih.gov/37326646/.
  • Johnny JD, Escobar J, Van Cao R, et al. The “8 D’s” of high-flow nasal cannula risk: A scoping review. Am J Crit Care. 2025;34(2):95-102. doi: 10.4037/ajcc2025855 https://pubmed.ncbi.nlm.nih.gov/40021356/.
  • Karbing DS, Kjærgaard S, Smith BW, et al. Variation in the PaO2/FiO2 ratio with FiO2: mathematical and experimental description, and clinical relevance. Crit Care. 2007;11(6):R118-R118. doi: 10.1186/cc6174 https://pubmed.ncbi.nlm.nih.gov/17988390/.
  • Karlsson N, Lindstrand FO, Johansson L, et al. Thermal intervention improves pulse oximetry accuracy in critically ill patients with low perfusion: a quasi-experimental study. J Intensive Care. 2026;14(1):8. doi: 10.1186/s40560-026-00847-w https://pubmed.ncbi.nlm.nih.gov/41514359/.
  • Lee GR. Clinical applications of blood gas analysis: a comparative review of arterial and venous blood gas monitoring in critical care. Acute Crit Care. 2025;40(2):153-159. doi: 10.4266/acc.000900 https://pubmed.ncbi.nlm.nih.gov/40494592/.
  • Martin DS, Doidge JC, Gould D, et al. The impact of skin tone on performance of pulse oximeters used by NHS England COVID Oximetry @home scheme: measurement and diagnostic accuracy study. BMJ. 2026;392:e085535. doi: 10.1136/bmj-2025-085535 https://pubmed.ncbi.nlm.nih.gov/41534914/.
  • Matthay MA, Arabi Y, Arroliga AC, et al. A new global definition of acute respiratory distress syndrome. Am J Respir Crit Care Med. 2023;doi: 10.1164/rccm.202303-0558WS https://pubmed.ncbi.nlm.nih.gov/37487152/.
  • McGuire WC, Sullivan L, Odish MF, et al. Management strategies for acute pulmonary embolism in the ICU. Chest. 2024;doi: 10.1016/j.chest.2024.04.032 https://pubmed.ncbi.nlm.nih.gov/38830402/.
  • Mitchell DA, Seckel MA. Acute respiratory distress syndrome and prone positioning. AACN Adv Crit Care. 2018;29(4):415-425. doi: 10.4037/aacnacc2018161 https://pubmed.ncbi.nlm.nih.gov/30523012/.
  • Page B. Assessing O2 Saturation: The how, what and why of pulse oximetry. JEMS. 2017;42(5):49-53. doi:  https://pubmed.ncbi.nlm.nih.gov/29227607/.
  • Pruitt B. Strategies for interpreting arterial blood gases. Nursing. 2024;54(1):16-21. doi: 10.1097/01.NURSE.0000995560.71478.3f https://pubmed.ncbi.nlm.nih.gov/38126981/.
  • Rezoagli E, Fumagalli R, Bellani G. Definition and epidemiology of acute respiratory distress syndrome. Ann Transl Med. 2017;5(14):282. doi: 10.21037/atm.2017.06.62 https://pubmed.ncbi.nlm.nih.gov/28828357/.
  • Rice TW, Wheeler AP, Bernard GR, et al. Comparison of the SpO2/FIO2 ratio and the PaO2/FIO2 ratio in patients with acute lung injury or ARDS. Chest. 2007;132(2):410-7. doi: 10.1378/chest.07-0617 https://pubmed.ncbi.nlm.nih.gov/17573487/.
  • Robinson BRH, Cohen MJ, Holcomb JB, et al. Risk factors for the development of acute respiratory distress syndrome following hemorrhage. Shock. 2018;50(3):258-264. doi: 10.1097/shk.0000000000001073 https://pubmed.ncbi.nlm.nih.gov/29194339/.
  • Saidy S, Iqbal A, Baig SH. Pulse oximetry discrepancies and occult hypoxemia in ICU patients: Predictors and clinical outcomes. J Intensive Care Med. 2025;40(12):1269-1278. doi: 10.1177/08850666251351594 https://pubmed.ncbi.nlm.nih.gov/40665879/.
  • Villar J, Szakmany T, Grasselli G, et al. Redefining ARDS: a paradigm shift. Crit Care. 2023;27(1):416. doi: 10.1186/s13054-023-04699-w https://pubmed.ncbi.nlm.nih.gov/37907946/.
  • Vlachou C, Argiriadou H, Amaniti A, et al. Acute respiratory distress syndrome in trauma patients: Treatment interventions and risks. Injury. 2026;57(4) doi: 10.1016/j.injury.2026.113113 https://pubmed.ncbi.nlm.nih.gov/41724015/
  • https://www.injuryjournal.com/article/S0020-1383(26)00100-2/pdf.
  • Wick KD, Matthay MA, Ware LB. Pulse oximetry for the diagnosis and management of acute respiratory distress syndrome. Lancet Respir Med. 2022;10(11):1086-1098. doi: 10.1016/s2213-2600(22)00058-3 https://pubmed.ncbi.nlm.nih.gov/36049490/.
  • Wong AI, Charpignon M, Kim H, et al. Analysis of discrepancies between pulse oximetry and arterial oxygen saturation measurements by race and ethnicity and association with organ dysfunction and mortality. JAMA Netw Open. 2021;4(11):e2131674. doi: 10.1001/jamanetworkopen.2021.31674 https://pubmed.ncbi.nlm.nih.gov/34730820/.