Cargando…
A Comprehensive Review of the Management of Acute Respiratory Distress Syndrome
Acute respiratory distress syndrome (ARDS) is an inflammatory process in the lungs that induces non-hydrostatic protein-rich pulmonary edema. ARDS occurs in roughly half of coronavirus disease 2019 (COVID-19) pneumonia patients, with most of them requiring intensive care. Oxygen saturation, partial...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9686454/ https://www.ncbi.nlm.nih.gov/pubmed/36439591 http://dx.doi.org/10.7759/cureus.30669 |
_version_ | 1784835752833581056 |
---|---|
author | Ajibowo, Abimbola O Kolawole, Olasunkanmi A Sadia, Haleema Amedu, Oyovwike S Chaudhry, Hassan A Hussaini, Helai Hambolu, Eloho Khan, Tuba Kauser, Humaira Khan, Aadil |
author_facet | Ajibowo, Abimbola O Kolawole, Olasunkanmi A Sadia, Haleema Amedu, Oyovwike S Chaudhry, Hassan A Hussaini, Helai Hambolu, Eloho Khan, Tuba Kauser, Humaira Khan, Aadil |
author_sort | Ajibowo, Abimbola O |
collection | PubMed |
description | Acute respiratory distress syndrome (ARDS) is an inflammatory process in the lungs that induces non-hydrostatic protein-rich pulmonary edema. ARDS occurs in roughly half of coronavirus disease 2019 (COVID-19) pneumonia patients, with most of them requiring intensive care. Oxygen saturation, partial pressure of the oxygen, and the fraction of the inspired oxygen are health indicators that may indicate a severe illness necessitating further investigation. As treatments have evolved, a typical pattern of ARDS has likewise evolved. In cases where mechanical ventilation is required, the use of low tidal volumes (<6 ml/kg ideal body weight) and airway pressures (plateau pressure <30 cmH(2)O) was recommended. For patients with moderate/severe ARDS (partial pressure to fractional inspired oxygen ratio <20), prone positioning was recommended for at least 16 hours per day. By contrast, high-frequency oscillation was not recommended. The use of inhaled vasodilators was recommended in patients with persistent hypoxemia despite invasive ventilation and prone position until extracorporeal membrane oxygenation (ECMO). The use of a conservative fluid management strategy was suggested for all patients. Mechanical ventilation with high positive end-expiratory pressure (PEEP) was suggested for patients with ARDS with a ratio of arterial oxygen partial pressure to fractional inspired oxygen (PF) ratios. ECMO was suggested as an adjunct to protective mechanical ventilation for patients with severe ARDS. In the absence of adequate evidence, research recommendations were made for corticosteroids and extracorporeal carbon dioxide removal. While decades of research have been conducted, treatment options for underlying pathologies remain limited, and mechanical ventilation, which removes carbon dioxide from the body, remains essential to achieving better clinical outcomes. This review aims to identify the best ARDS treatments that are currently available. |
format | Online Article Text |
id | pubmed-9686454 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-96864542022-11-25 A Comprehensive Review of the Management of Acute Respiratory Distress Syndrome Ajibowo, Abimbola O Kolawole, Olasunkanmi A Sadia, Haleema Amedu, Oyovwike S Chaudhry, Hassan A Hussaini, Helai Hambolu, Eloho Khan, Tuba Kauser, Humaira Khan, Aadil Cureus Internal Medicine Acute respiratory distress syndrome (ARDS) is an inflammatory process in the lungs that induces non-hydrostatic protein-rich pulmonary edema. ARDS occurs in roughly half of coronavirus disease 2019 (COVID-19) pneumonia patients, with most of them requiring intensive care. Oxygen saturation, partial pressure of the oxygen, and the fraction of the inspired oxygen are health indicators that may indicate a severe illness necessitating further investigation. As treatments have evolved, a typical pattern of ARDS has likewise evolved. In cases where mechanical ventilation is required, the use of low tidal volumes (<6 ml/kg ideal body weight) and airway pressures (plateau pressure <30 cmH(2)O) was recommended. For patients with moderate/severe ARDS (partial pressure to fractional inspired oxygen ratio <20), prone positioning was recommended for at least 16 hours per day. By contrast, high-frequency oscillation was not recommended. The use of inhaled vasodilators was recommended in patients with persistent hypoxemia despite invasive ventilation and prone position until extracorporeal membrane oxygenation (ECMO). The use of a conservative fluid management strategy was suggested for all patients. Mechanical ventilation with high positive end-expiratory pressure (PEEP) was suggested for patients with ARDS with a ratio of arterial oxygen partial pressure to fractional inspired oxygen (PF) ratios. ECMO was suggested as an adjunct to protective mechanical ventilation for patients with severe ARDS. In the absence of adequate evidence, research recommendations were made for corticosteroids and extracorporeal carbon dioxide removal. While decades of research have been conducted, treatment options for underlying pathologies remain limited, and mechanical ventilation, which removes carbon dioxide from the body, remains essential to achieving better clinical outcomes. This review aims to identify the best ARDS treatments that are currently available. Cureus 2022-10-25 /pmc/articles/PMC9686454/ /pubmed/36439591 http://dx.doi.org/10.7759/cureus.30669 Text en Copyright © 2022, Ajibowo et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Ajibowo, Abimbola O Kolawole, Olasunkanmi A Sadia, Haleema Amedu, Oyovwike S Chaudhry, Hassan A Hussaini, Helai Hambolu, Eloho Khan, Tuba Kauser, Humaira Khan, Aadil A Comprehensive Review of the Management of Acute Respiratory Distress Syndrome |
title | A Comprehensive Review of the Management of Acute Respiratory Distress Syndrome |
title_full | A Comprehensive Review of the Management of Acute Respiratory Distress Syndrome |
title_fullStr | A Comprehensive Review of the Management of Acute Respiratory Distress Syndrome |
title_full_unstemmed | A Comprehensive Review of the Management of Acute Respiratory Distress Syndrome |
title_short | A Comprehensive Review of the Management of Acute Respiratory Distress Syndrome |
title_sort | comprehensive review of the management of acute respiratory distress syndrome |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9686454/ https://www.ncbi.nlm.nih.gov/pubmed/36439591 http://dx.doi.org/10.7759/cureus.30669 |
work_keys_str_mv | AT ajibowoabimbolao acomprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT kolawoleolasunkanmia acomprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT sadiahaleema acomprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT ameduoyovwikes acomprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT chaudhryhassana acomprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT hussainihelai acomprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT hambolueloho acomprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT khantuba acomprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT kauserhumaira acomprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT khanaadil acomprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT ajibowoabimbolao comprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT kolawoleolasunkanmia comprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT sadiahaleema comprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT ameduoyovwikes comprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT chaudhryhassana comprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT hussainihelai comprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT hambolueloho comprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT khantuba comprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT kauserhumaira comprehensivereviewofthemanagementofacuterespiratorydistresssyndrome AT khanaadil comprehensivereviewofthemanagementofacuterespiratorydistresssyndrome |