IntroductionAcute respiratory distress syndrome (ARDS) after mild traumatic brain injury (TBI) can be associated with significant morbidity and mortality. This study aimed to evaluate the potential predictive factors of ARDS development following mild TBI in trauma patients. MethodsA retrospective chart review was done for adult trauma patients with mild TBI (GCS 13-15) requiring admission at our center from 2012 to 2020. Linear regression analysis and chi-square test were utilized to identify independent predictors of the association with ARDS in adults with mild TBI. ResultsA total of 784 mild TBI patients were admitted during the time of interest; 34 patients developed ARDS during their index hospitalization. Patients who had ARDS were more likely to have acute kidney injury (AKI; p < 0.0001), sepsis (p < 0.01), rib fractures (p < 0.05), use of anticoagulants (p < 0.001), deep vein thrombosis (p < 0.001), transfusion during the first 4four hours upon admission (p = 0.01), intravenous fluid (IVF) resuscitation during the first four hours (p <0.05), the first eight hours (p = 0.01), the first 12 hours (p = 0.03), and intubation upon the admission (p < 0.0001). ARDS associated with mild TBI demonstrated a statistically significant increase in mortality during the index hospitalization (p < 0.0001). ConclusionARDS after mild TBI can be associated with significant morbidity and mortality. Key risk factors identified include AKI, sepsis, anticoagulant use, deep vein thrombosis (DVT), transfusion in the first four hours, IVF resuscitation in the first four, eight, and 12 hours, and intubation upon admission.

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above the posterior aponeurosis; intraperitoneal (IPOM) -mesh adjacent to the transversalis fascia. After 60 days of the act, adhesions, tensiometry (maximum tension strengh; MTS), histology and immunohistochemistry (mannose receptors and CD 68 expression) were evaluated.RESULTS: IPOM obtained the highest number of adhesions, with an average of 3.4 (p <0.0001). SL presented higher values in the tensiometric evaluation, mean of 36.75 N and lower mean IPOM, 6.58 N (p <0.0001). Histology demonstrated greater expression of the production of inflammatory, polymorphonuclear cells and fibroblasts in SL (p <0.0001). Immunohistochemical findings showed greater expression of mannose receptors and CD68 receptors in the SL group (p 0,01 and p 0,001, respectively). CONCLUSION:The mesh in the retromuscular compartment caused an increase in tensiometry. The intraperitoneal group showed an exacerbated intensity of adhesions. The histological and immunohistochemical findings reinforce demonstrate an optimized healing process in the SL group. We affirm that corrections of incisional hernias by the retromuscular technique generate a better fibrogenesis.

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