Simple jQuery Dropdowns
Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/46820
Title: ARDS: Challenges in patient care and frontiers in research
Authors: Lieuwe D. Bos
Ignacio Martin-Loeches
Marcus J. Schultz
Mahidol University
Trinity College Dublin
Amsterdam UMC - University of Amsterdam
Keywords: Medicine
Issue Date: 31-Mar-2018
Citation: European Respiratory Review. Vol.27, No.147 (2018)
Abstract: © ERS 2018. This review discusses the clinical challenges associated with ventilatory support and pharmacological interventions in patients with acute respiratory distress syndrome (ARDS). In addition, it discusses current scientific challenges facing researchers when planning and performing trials of ventilatory support or pharmacological interventions in these patients. Noninvasive mechanical ventilation is used in some patients with ARDS. When intubated and mechanically ventilated, ARDS patients should be ventilated with low tidal volumes. A plateau pressure <30 cmH2O is recommended in all patients. It is suggested that a plateau pressure <15 cmH2O should be considered safe. Patient with moderate and severe ARDS should receive higher levels of positive endexpiratory pressure (PEEP). Rescue therapies include prone position and neuromuscular blocking agents. Extracorporeal support for decapneisation and oxygenation should only be considered when lungprotective ventilation is no longer possible, or in cases of refractory hypoxaemia, respectively. Tracheotomy is only recommended when prolonged mechanical ventilation is expected. Of all tested pharmacological interventions for ARDS, only treatment with steroids is considered to have benefit. Proper identification of phenotypes, known to respond differently to specific interventions, is increasingly considered important for clinical trials of interventions for ARDS. Such phenotypes could be defined based on clinical parameters, such as the arterial oxygen tension/inspiratory oxygen fraction ratio, but biological marker profiles could be more promising.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85041298716&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/46820
ISSN: 16000617
09059180
Appears in Collections:Scopus 2018

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.