To analyze the reasons for this, vascular endothelial damage after severe thoracic trauma can cause a large release of thrombomodulin (TM) and participate in regulating the coagulation process of the body, leading to microthrombus formation in the lung, microcirculatory blockage and structural damage, inducing pulmonary capillary spasm and increased permeability, activating inflammatory cells, and thus inducing the development of ARDS (22). Here, THBD is linked to acute respiratory distress syndrome.