Tag: ARDS

Upvote Story 8
This book describes the techniques, strategies, and drugs that have been demonstrated by multicenter randomized trials to influence survival in critically ill patients, defined as those who have acute failure of at least one organ, due to either a pathological condition or a medical intervention, and require intensive care treatment. Each chapter focuses on a specific procedure, device, or drug. The scope is accordingly wide,... Read More | Comment
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In light of emerging data from clinical trials, the place of high-frequency oscillatory ventilation (HFOV) in the management of acute respiratory distress syndrome (ARDS) is uncertain. Although not first-line, HFOV remains a tool in the armamentarium of the intensivist managing the patient with severe ARDS and refractory hypoxemia. A refinement in the approach to delivering HFOV is warranted, with more attention paid to its adverse... Read More | Comment
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Hospital mortality in acute respiratory distress syndrome (ARDS) is approximately 40%, but mortality and trajectory in “mild” acute respiratory distress syndrome (classified only since 2012) are unknown, and many cases are not detected. Approximately 80% of cases of mild acute respiratory distress syndrome persist or worsen in the first week; in all cases, the mortality is substantial (30%) and is higher (37%) in those in... Read More | Comment
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Acute respiratory distress syndrome (ARDS) results in substantial mortality but remains underdiagnosed in clinical practice. For this reason, automated “sniffer” systems that analyse electronic records have been developed to assist clinicians with ARDS diagnosis. However, a new systematic review found that these sniffer tools had moderate to high predictive value in their derivation cohorts, indicating that published literature had potential for high risks of bias... Read More | Comment
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The efficacy of corticosteroid use in acute respiratory distress syndrome (ARDS) remains controversial. Generally, short-term high-dose corticosteroid therapy is considered to be ineffective in ARDS. On the other hand, low-dose, long-term use of corticosteroids has been reported to be effective since they provide continued inhibition of the systemic inflammatory response syndrome (SIRS) that accompanies ARDS. Thus far, no reports have been published on the efficacy... Read More | Comment
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Intubation and mechanical ventilation are commonly performed ED interventions and although patients optimally go to an ICU level of care afterwards, many of them remain in the ED for prolonged periods of time. It is widely accepted that the utilization of lung-protective ventilation reduces ventilator-associated complications including acute respiratory distress syndrome (ARDS). Additionally, it is believed that ventilatory-associated lung injury can occur early after the... Read More | Comment
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Patients who survive acute respiratory distress syndrome (ARDS) often leave ICU with debilitating mental, physical, or cognitive problems that may limit their quality of life. These challenges are called post-intensive care syndrome (PICS). The survivors may live with long-term effects, including permanent lung damage and different degrees of physical, cognitive, and mental health problems. Now, a new study of 645 ARDS survivors by researchers at... Read More | Comment
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Use of initial tidal volumes less than 8 ml/kg PBW is common at hospitals participating in the NHLBI PETAL Network. After considering the size and budgetary requirement for a cluster-randomized trial of LTVV vs. usual care in acute respiratory failure (ARF), the PETAL network deemed the proposed trial infeasible. A rapid observational study and simulations to model anticipated power may help better design trials. We... Read More | Comment
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This well-illustrated book provides detailed guidance on all aspects of physical examination in patients requiring emergency or intensive care. After an introductory section covering basic principles and the recognition of pre-terminal signs, the approach to examination of individual organ systems is clearly explained. Examination schemes are then presented for particular conditions or settings, including respiratory distress, shock, neurological disease, trauma, suspected infection, and cardiac arrest.... Read More | Comment
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Since 1980, Fishman’s Pulmonary Diseases and Disorders has delivered unparalleled coverage of pulmonary medicine and the underlying basic and applied science upon which clinical practice is based. The Fifth Edition, with 270 contributing authors, includes over 2,000 illustrations, 60 videos, and 18,000 references. The book opens with a comprehensive overview of the scientific basis of lung function in health and disease. It then provides detailed... Read More | Comment
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The consensus definitions of acute respiratory distress syndrome (ARDS) mainly rely on feasible clinical criteria, which help to group patients together for inclusion in clinical trials and for clinical management. This generates clinical and biological differences in observable patient characteristics. These differences could be used to group ARDS patients, referred to as ARDS subphenotypes, according to an article in Intensive Care Medicine. Identifying ARDS subphenotypes... Read More | Comment
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Survivors of critical illness frequently experience poor physical outcomes, including persistent impairments in muscle strength, exercise capacity and physical function. In this article, we review these impairments and recent clinical trials evaluating physical rehabilitation during critical illness as a potential means to improve these outcomes, and conclude with considerations for future studies in the field. Muscle wasting and weakness commonly develops within days of ICU... Read More | Comment
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Our study confirmed an association between higher driving pressure and higher mortality in mechanically ventilated patients with acute respiratory distress syndrome (ARDS). These findings suggest a possible range of driving pressure to be evaluated in clinical trials. Future research is needed to ascertain the benefit of ventilatory strategies targeting driving pressure in patients with acute respiratory distress syndrome. In the meta-analyses of four studies (3,252... Read More | Comment
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Critical care transport of prone acute respiratory distress syndrome (ARDS) patients is a feasible and cost-effective intervention that will help prevent treatment delays and interruptions. A nonphysician critical care transport team (registered nurse and paramedic) can initiate prone positioning before transport. We report the case of a non-physician based critical care transport team (registered nurse and paramedic) that successfully initiated prone positioning of a severe... Read More | Comment
Upvote Story 7
In patients in the Intensive Care Unit (ICU) without acute respiratory distress syndrome (ARDS) who were expected not to be extubated within 24 hours of randomization, a low tidal volume strategy did not result in a greater number of ventilator-free days than an intermediate tidal volume strategy. In total, 961 patients (65% male), with a median age of 68 years (interquartile range [IQR], 59-76), were... Read More | Comment