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Background Severe thoracic trauma affects 55% of patients with multiple traumatic injuries and may lead to acute lung injury or acute respiratory distress syndrome. Pulmonary trauma differs clinically and biologically from lung injury of other origins and carries a mortality rate of 10%. Treatment options are limited, and it is not possible to monitor the progression of lung injury with specific biomarkers. Microdialysis of pleural fluid may offer a viable entry to monitor the lung directly and specifically. Bronchial microdialysis has