Spezifische Therapie des akuten Lungenversagens

Due to a high heterogeneity and dynamic changes in the course of acute respiratory distress syndrome (ARDS), intensive care physicians are faced with extraordinary challenges. While the current definition, pathophysiology and differential diagnoses were previously addressed in this journal, this article focuses on some specific and individualized treatment options. Ventilation treatment with limitation of tidal volumes and pressure amplitudes has been shown to be advantageous with respect to mortality. Nevertheless, because of the multifactorial etiology of ARDS in the context of individual circumstances, this strategy needs to be adjusted to each patient’s needs. In recent years it has become increasingly evident that prone positioning, early spontaneous breathing and early mobilization improve the course of the disease. Therefore, an individualized treatment should consider these issues and take the characteristics of the patient and the specific disease progression into account.