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Pulmonary contusion is the principal risk factor, although extra-thoracic injuries\u2014including traumatic brain injury, abdominal trauma, and long bone fractures\u2014further increase ARDS incidence and complicate management. Early application of damage control strategies, including judicious fluid resuscitation and balanced blood product transfusion, can mitigate these risks. This review examines principles of mechanical ventilation in trauma-induced ARDS, with emphasis on protective ventilation strategies. Yet, trauma-specific contexts\u2014such as persistent air leaks, flail chest, abdominal hypertension, and intracranial hypertension\u2014require tailored adaptations. Prone positioning improves oxygenation in severe hypoxemia, though data in trauma are limited. Alternative ventilation modes and extracorporeal membrane oxygenation (ECMO) represent a rescue therapy in refractory cases; veno-venous ECMO offers feasible survival benefits despite bleeding concerns, whereas veno-arterial ECMO is associated with poorer outcomes. Ultimately, management of trauma-related respiratory failure requires a personalized approach, balancing conventional and advanced ventilatory strategies to optimize outcomes.<\/jats:p>","DOI":"10.1177\/19433654261428443","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T11:28:18Z","timestamp":1773401298000},"page":"405-416","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mechanical Ventilation in Trauma-Induced Respiratory Failure: A Clinical Review"],"prefix":"10.1177","volume":"71","author":[{"given":"Carolina","family":"Ruiz","sequence":"first","affiliation":[{"name":"Dr. Ruiz, Dr. Aquevedo, Miss. Marambio-Coloma, Ms. Arqueros, Prof. Bugedo, and Prof. Damiani are affiliated with the Unidad de Paciente Cr\u00edtico, Complejo Asistencial S\u00f3tero del R\u00edo, Servicio de Salud Metropolitano Sur Oriente, Santiago, Chile."},{"name":"Dr. Ruiz, Dr. Aquevedo, Miss. Marambio-Coloma, Ms. Arqueros, Prof. Bugedo, and Prof. Damiani are affiliated with the Departamento Kinesiolog\u00eda, Escuela de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Cat\u00f3lica de Chile, Santiago, Chile."},{"name":"Dr. Ruiz, Dr. Aquevedo, Miss. Marambio-Coloma, Ms. Arqueros, Prof. Bugedo, and Prof. Damiani are affiliated with the Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Cat\u00f3lica de Chile, Santiago, Chile."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"Aquevedo","sequence":"additional","affiliation":[{"name":"Dr. Ruiz, Dr. Aquevedo, Miss. 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