Tag: ARDS
How Best to Set the Ventilator on Extracorporeal Membrane Lung Oxygenation
Mechanical ventilation and extracorporeal support are marginally integrated. The best environment for lung healing – complete lung collapse or protective ventilation strategy or fully open and immobile lung (all three conditions... read more
TPTD Techniques in the Hemodynamically Unstable Patient
Transpulmonary thermodilution (TPTD) devices invasively measure not only cardiac output but also several other hemodynamic variables estimating cardiac preload, cardiac preload, systolic function, the lung oedema and systolic... read more
The negative effect of initial high-dose methylprednisolone and tapering regimen for ARDS
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,... read more
Time-Course of Clinical Physiologic Variables in ARDS Patients Undergoing ECMO
In patients undergoing extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS), it is unknown which clinical physiologic variables should be monitored to follow the evolution of lung injury... read more
Clustering Algorithms Usage in Critical Care Research Unravel Patient Heterogeneity
Critically ill patients constitute the most heterogeneous population in the hospital, with the highest rates of acute and chronic multi-morbidity. Daily, two critically ill patients are admitted to the ICU with the same... read more
Systemic Early Neuromuscular Blockade in ARDS – The ROSE Trial
The early use of neuromuscular blocking agents in the setting of moderate-to-severe acute respiratory distress syndrome (ARDS) was previously understood to confer a survival advantage at 90 days, based on the outcomes of... read more
ARDS Survivors Often Leave ICU with Prolonged PICS
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... read more
Early Neuromuscular Blockade in the ARDS
Among patients with moderate-to-severe ARDS who were treated with a strategy involving a high PEEP, there was no significant difference in mortality at 90 days between patients who received an early and continuous cisatracurium... read more
Phenotyping: Need to Identify Subgroups of ARDS Patients
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... read more
Driving Pressure in Airway Pressure Release Ventilation: a fool’s errand?
In this post I will briefly explain and critique their mathematical approach, propose a simpler equation for estimating PEEPi in APRV [based on far fewer physiological assumptions] and finally reaffirm why, in my opinion,... read more
Noninvasive Ventilation Through the Helmet Can Be Used For Early Mild and Moderate ARDS
Debating data have been published as regards the beneficial or deleterious effect of spontaneous breathing (SB) in comparison to controlled mechanical ventilation (CMV) during acute respiratory failure. Spontaneous breathing... read more
Effect of a Low vs Intermediate Tidal Volume Strategy on Ventilator-Free Days in ICU Patients Without ARDS
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... read more
Neuromuscular Blockade for ARDS Was No Help, In Supine Patients
Continuous neuromuscular blockade for severe ARDS became common practice after the ACURASYS trial showed it reduced mortality by an absolute 9%. A larger trial, ROSE, now finds no benefit of the therapy over usual care, but... read more
Optimizing Respiratory Management in Resource-limited Settings
This review focuses on the emerging body of literature regarding the management of acute respiratory failure (ARF) in low- and middle-income countries (LMICs). The aim is to abstract management principles that are of relevance... read more
Sedation Practice in ECMO-Treated Patients with ARDS
Our objective was to characterize sedation management in adult patients with severe respiratory distress syndrome (ARDS) treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). We conducted a retrospective... read more
Tidal Volume Strategies for those without ARDS
This paper justifies utilizing a higher tidal volume strategy for our patients without primary ARDS/pulmonary disease. This can be very useful. Patient comfort and patient-ventilator synchrony are extremely important. This... read more
Heterogeneity of Treatment Effect by Baseline Risk of Mortality in Critically ill Patients
Randomised controlled trials (RCTs) enrolling patients with sepsis or acute respiratory distress syndrome (ARDS) generate heterogeneous trial populations. Non-random variation in the treatment effect of an intervention due... read more
Economic Evaluation of vv-ECMO for Severe ARDS
Venovenous extracorporeal membrane oxygenation (vv-ECMO) is increasingly being used to support patients with severe acute respiratory distress syndrome (ARDS), but its cost-effectiveness is unknown. The cost-utility of vv-ECMO... read more
Applied Physiology at the Bedside: Volumetric Capnography
Volumetric capnography is the graphical representation of the partial pressure of carbon dioxide (CO2) versus exhaled volume. This measurement is made noninvasively at every breath by a combination of flow and CO2 sensors,... read more
A Prospective Investigation of Interleukin-8 Levels in Pediatric ARF and ARDS
The association of plasma interleukin-8 (IL-8), or IL-8 genetic variants, with pediatric acute respiratory distress syndrome (PARDS) in children with acute respiratory failure (ARF) at risk for PARDS has not been examined.... read more
The Evolution of Lung Protective Ventilation in ARDS
Dr. Jesus Villar is Group Chief of the Center for Biomedical Research in Respiratory Diseases in Madrid and Senior Scientist of the Research Unit at the Hospital Universitario Dr. Negrin in Las Palmas, Spain. He is the Coordinator... read more
Neutrophil Extracellular Traps Are Elevated in Patients with Pneumonia-related ARDS
Bronchoalveolar neutrophil extracellular trap concentration was not significantly associated with mechanical ventilation duration in pneumonia-related ARDS. The acute respiratory distress syndrome (ARDS) is the most severe... read more
