الفهرس | Only 14 pages are availabe for public view |
Abstract Acute Respiratory Distress Syndrome (ARDS) is a common entity in critical care. ARDS is associated with many diagnoses, including trauma and sepsis, can lead to multiple organ failure and has high mortality. Supportive measures in the management of ARDS include attention to fluid balance, restrictive transfusion strategies and the use of corticosteroids is also important, and appropriate timely use may reduce mortality. Prone position as rescue therapy for severe hypoxemia and high frequency ventilation, and minimization of sedatives and neuromuscular blocking agents. Inhaled bronchodilators such as inhaled nitric oxide and prostaglandins confer short term improvement without proven effect on survival, but are currently used in many centers. Extra corporeal oxygenation methods are very useful as rescue therapy in patients with intractable hypoxemia, even though a survival benefit has not, to this date been demonstrated.Many pharmacologic and supportive strategies have shown promising results, but data from large randomized clinical trials are needed to fully evaluate the true effectiveness of these therapies. Recent developments in the therapeutic approach to ARDS include refinements of mechanical ventilatory support with emphasis on protective lung ventilation using low tidal volumes, increased PEEP with use of recruitment maneuvers to promote reopening of collapsed lung alveoli, Despite intense ongoing research on the pathophysiology and treatment of ARDS, mortality remains high. |