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What Is the Best Strategy for Ventilation in Acute Respiratory Distress Syndrome?

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You’re Wrong, I’m Right

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Abstract

A 52-year-old man who was a pedestrian struck by a car is a patient in your intensive care unit (ICU). No history is known, and no one has been able to reach his family. The impact was mainly on his left chest and abdomen, and the patient required intubation upon arrival to the emergency department. A computed tomography (CT) scan upon admission showed a pulmonary contusion, along with 2 rib fractures. The patient’s condition has been worsening, and a chest X-ray (CXR) shows complete whiteout of both lungs. A partial pressure of oxygen/inspired fraction of oxygen (PaO2/FiO2) ratio of 90 is calculated, and the diagnosis of severe acute respiratory distress syndrome (ARDS) is made.

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References

  1. Petrucci N, De Feo C. Lung protective ventilation strategy for the acute respiratory distress syndrome. Cochrane Database Syst Rev. 2013;2:CD003844.

    Google Scholar 

  2. Rittayamai N, Brochard L. Recent advances in mechanical ventilation in patients with acute respiratory distress syndrome. Eur Respir Rev. 2015;24:132–40.

    Article  PubMed  Google Scholar 

  3. Meade MO, Cook DJ, Guyatt GH, Slutsky AS, Arabi YM, Cooper DJ, et al. Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome: a randomized controlled trial. JAMA. 2008;299(6):637–45.

    Article  CAS  PubMed  Google Scholar 

  4. Briel M, Meade M, Mercat A, Brower R, Talmor D, Walter S, et al. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA. 2010;303(9):865–73.

    Article  CAS  PubMed  Google Scholar 

  5. Pintado MC, dePablo R, Trascasa M, Milicua JM, Rogero S, Daguerre M, et al. Individualized PEEP setting in subjects with ARDS: a randomized controlled pilot study. Respir Care. 2013;58(9):1416–23.

    Article  PubMed  Google Scholar 

  6. Yoshida T, Uchiyama A, Matsuura N, Mashimo T, Fujino Y. Spontaneous breathing during lung-protective ventilation in an experimental acute lung injury model: high transpulmonary pressure associated with strong spontaneous breathing effort may worsen lung injury. Crit Care Med. 2012;40(5):1578–85.

    Article  PubMed  Google Scholar 

  7. Fan E, Dowdy DW, Colantuoni E, Mendez-Tellez PA, Sevransky JE, Shanholtz C. Physical complications in acute lung injury survivors: a 2-year longitudinal prospective study. Crit Care Med. 2014;42(4):849–59.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Alhazzani W, Alshahrani M, Jaeschke R, Forel JM, Papazian L, Sevranksy J, Meade MO. Neuromuscular blocking agents in acute respiratory distress syndrome: a systematic review and meta-analysis of randomized controlled trials. Crit Care. 2013;17:R43.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, New York University/Bellevue, 550 First Avenue, New York, New York, 10016, USA

    Lee Stein

  2. 5 Peter Cooper Road, Apt 3E, New York, New York, 10010, USA

    Lee Stein

Authors
  1. Lee Stein
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Correspondence to Lee Stein .

Editor information

Editors and Affiliations

  1. Clinical Professor of Anesthesiology, Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University School of Medicine, New York, New York, USA

    Corey S. Scher

  2. Assistant Professor, Department of Anesthesia and Critical Care, The University of Chicago, Chicago, Illinois, USA

    Anna Clebone

  3. Clinical Professor of Anesthesiology (Emeritus), Former Assistant Director of Anesthesiology, Bellevue Hospital Center Retired from Department of Anesthesiology, Bellevue Hospital Center, New York University School of Medicine, New York, New York, USA

    Sanford M. Miller

  4. Clinical Associate Professor of Anesthesiology and Surgery, Bellevue Hospital Center, Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University School of Medicine, Surgical Intensive Care Unit, New York, New York, USA

    J. David Roccaforte

  5. Department of Anesthesiology, Perioperative Care and Pain Medicine, Vice Chair Faculty Promotion Associate Director Anesthesia Service Bellevue Hospital Center, New York, New York, USA

    Levon M. Capan

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Stein, L. (2017). What Is the Best Strategy for Ventilation in Acute Respiratory Distress Syndrome?. In: Scher, C., Clebone, A., Miller, S., Roccaforte, J., Capan, L. (eds) You’re Wrong, I’m Right. Springer, Cham. https://doi.org/10.1007/978-3-319-43169-7_72

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  • DOI: https://doi.org/10.1007/978-3-319-43169-7_72

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43167-3

  • Online ISBN: 978-3-319-43169-7

  • eBook Packages: MedicineMedicine (R0)

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