Objective   To investigate the the feasibility and safety of continuous sedation and analgesia in acute respiratory distress syndrome (ARDS) after severe chest trauma complicated with multiple severe injuries.  Methods   A total of 72 ARDS patients with severe chest trauma and multiple severe injuries hospitalized in our department from May 2002 to December 2009 were retrospectively studied. Continuous sedation and analgesia associate with naloxone treatment (2 mg

in 6 h after removal of patients controlled analgesia) were carried out in 21 cases (group Ⅰ)

simple continuous sedation and analgesia in 28 cases (group Ⅱ)

and intermittent analgesia and sedation in 23 cases ( group Ⅲ). Continuous dynamic blood pressure

electrocardiogram

heart rate (HR) and oxyhemoglobin saturation (SaO2) were measured. Blood routine examination and blood gas analysis were carried out constantly. Medical ventilator was used to measrue spontaneous breathing tidal volume (Vt)

minute ventination volume (MVV)

airway pressure (Paw) and plateau pressure (Pplat) before and after treatment. Oxygenation index (OI) was calculated

and respiratory function

complications

ventilation time and ICU stay were analyzed.   Results  There was no significance among the 3 groups in injury severity score (ISS)

acute physiology and chronicity health evaluation Ⅱ (APACHE Ⅱ) score

arterial carbon dioxide partial pressure [P(CO2)]

OI

Paw

and Vt. In each group after treatment

all indicators were improved and there was no significant difference in carbon dioxide retention (P0.05). But Paw

Pplat and OI were increased

Vt and MVV were improved most significantly in group Ⅰ

while respiratory depression

pulmonary infection

cardiac insufficiency and cardiac arrhythmia and other complications were lower compared with those in the other 2 groups. The irritability

euphoria and other nervous system symptoms

nausea

vomiting and other gastrointestinal tract symptoms were similar to those in group Ⅲ. The mechanical ventilation time and ICU stay were shortest in group Ⅰ.  Conclusion  It is safe and useful of continuous sedation and analgesia in the treatment of ARDS in severe chest trauma patients with multiple severe injuries. And naloxone is helpful in removal of ventilation as early as possible.