Acute Respiratory Distress Syndrome (ARDS)
Acute respiratory distress syndrome is underrecognized and has a >40% mortality in moderate-to-severe disease. Recognition utilizing the Berlin definition clarifies the mortality risk and drives treatment efforts maximizing survival. Lung protective strategies as well as neuromuscular blockade and prone positioning have been shown to have a survival advantage. Measurement of driving pressure and trans-pulmonary pressure may impede injury to the lung. Recruitment maneuvers and directed fluid management strategy may benefit certain ARDS patients. Optimal care of the ARDS patient includes the ABCDEF bundle.
KeywordsAcute respiratory distress syndrome (ARDS) Berlin definition Positive end-expiratory pressure (PEEP) Plateau pressure Neuromuscular blockade agents Prone positioning Driving pressure Trans-pulmonary pressure Recruitment maneuvers Subphenotypes of ARDS ABCDEF bundle
- 6.Chiumello D, Cressoni M, Carlesso E, et al. Bedside selection of positive end-expiratory pressure in mild, moderate and severe acute respiratory distress syndrome. Crit Care Med. 2013;42(2):1–13.Google Scholar
- 16.Gebistorf F, Karam O, Wetterslev J, Afshari A. Inhaled nitric oxide for ARDS in children and adults. Cochrane Database Syst Rev. 2016;(6). Art. No.:CD002787.Google Scholar