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Acute Respiratory Distress Syndrome

Yadam, Suman MD; Bihler, Eric MD; Balaan, Marvin MD

doi: 10.1097/CNQ.0000000000000111
Original Articles
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Acute respiratory distress syndrome (ARDS) is a serious inflammatory disorder with high mortality. Its main pathologic mechanism seems to result from increased alveolar permeability. Its definition has also changed since first being described according to the Berlin definition, which now classifies ARDS on a severity scale based on PaO2 (partial pressure of oxygen, arterial)/FIO2 (fraction of inspired oxygen) ratio. The cornerstone of therapy was found to be a low tidal volume strategy featuring volumes of 6 to 8 mL per kg of ideal body weight that has been shown to have decreased mortality as proven by the ARDSnet trials. There are other areas of treatment right now that include extracorporeal membrane oxygenation, as well for severe refractory hypoxemia. Other methods that include prone positioning for ventilation have also shown improvements in oxygenation. Positive end-expiratory pressure with lung recruitment maneuvers has also been found to be helpful. Other therapies that include vasodilators and neuromuscular agents are still being explored and need further studies to define their role in ARDS.

Allegheny Health Network, Division of Pulmonary and Critical Care, Pittsburgh, Pennsylvania.

Correspondence: Suman Yadam, MD, Allegheny Health Network, Division of Pulmonary and Critical Care, 490 East North Avenue, Suite 300, Pittsburgh, PA 15212 (syadam@wpahs.org).

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

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