Tag: ARDS
Prone Positioning for a Morbidly Obese Patient with ARDS
Since the description in the 1970s of external positive end-expiratory pressure for acute respiratory distress syndrome (ARDS), the optimum level of external positive end-expiratory pressure remains unresolved. In the 1990s,... read more
Lumping or Splitting in Pediatric ARDS
Improvements in acute respiratory distress syndrome (ARDS) outcomes in adults have been achieved along-side demonstration of the superiority of low-tidal volume ventilation, the relative advantage of a restrictive fluid strategy... read more
ECMO for Severe ARDS
Mr. Jackson is a 36-year-old man whom you are caring for in the intensive care unit (ICU). Before this hospitalization, he was healthy and took no medications. He has never smoked, and he drinks three or four beers every... read more
Chest Radiography vs. Lung Ultrasound for Identification of ARDS
For the identification of acute respiratory distress syndrome (ARDS) using the Berlin definition, both chest radiography and lung ultrasound were equally related to mortality. The Berlin definition using lung ultrasound helped... read more
Intensive care in severe malaria: Report from the task force on tropical diseases by the WFSICCM
Severe malaria is common in tropical countries in Africa, Asia, Oceania and South and Central America. It may also occur in travelers returning from endemic areas. Plasmodium falciparum accounts for most cases, although P... read more
Diagnostic Accuracy of Chest Radiograph, and When Concomitantly Studied Lung Ultrasound, in Critically Ill Patients With Respiratory Symptoms
This meta-analysis demonstrates that chest radiograph has a low sensitivity and reasonable specificity compared with CT for detecting lung pathology in critically ill patients. The studies also investigating lung ultrasound,... read more
Oxygenate, Ventilate, Do No Harm
Emergency physicians (EPs) are experts in emergent airway management and thus must be confident managing mechanical ventilation. Hospital-wide bed shortages mean that EPs will be managing admitted patients for longer periods... read more
The Effect of Alcohol Consumption on the Risk of ARDS
Chronic high alcohol consumption significantly increases the risk of ARDS. This finding suggests that patients admitted to hospital should be screened for chronic alcohol use. Seventeen observational studies (177,674 people)... read more
Prolonged Glucocorticoid Treatment is Associated with Improved ARDS Outcomes
Prolonged methylprednisolone treatment accelerates the resolution of ARDS, improving a broad spectrum of interrelated clinical outcomes and decreasing hospital mortality and healthcare utilization. We conducted two sets of... read more
Mechanical Ventilation Induces Desensitization of Lung Axl Tyrosine Kinase Receptors
These data suggest that lung endothelial cell overdistention activates ion channels, and the resultant influx of Ca2+ inactivates Axl. Downstream inactivation of Axl by stretch was not anticipated; preventing this would be... read more
Positive End-Expiratory Pressure Lower Than the ARDS Network Protocol Is Associated with Higher Pediatric ARDS Mortality
Patients with PARDS managed with lower PEEP relative to FiO2 than recommended by the ARDSNet model had higher mortality. Clinical trials targeting PEEP management in PARDS are needed. This was a multicenter, retrospective... read more
Low Tidal Volume Ventilation in ARDS
In this "Breathe Easy Critical Perspective" podcast, Dr. Dominique Pepper interviews Dr. Allan Walkey. They discuss low tidal volume ventilation in ARDS. Dr. Walkey is the chair of the Early Career Professional Working Group... read more
Timing of Renal Support and Outcome of Septic Shock and ARDS
Early RRT initiation strategy was not associated with any improvement of 60-day mortality in patients with severe acute kidney injury and septic shock or Acute Respiratory Distress Syndrome (ARDS). Unnecessary and potentially... read more
The Efficacy of ECMO for Severe ARDS
The H1N1 epidemic demonstrated that extracorporeal membrane oxygenation (ECMO) use in the most critically ill patients with acute respiratory distress syndrome (ARDS) resulted in a substantial decrease in mortality. The CESAR... read more
Management and Outcomes of ARDS Patients With and Without Comorbid Conditions
Half the patients with acute respiratory distress syndrome (ARDS) had major comorbidities, which were associated with severe ARDS, multiple organ dysfunction, and day‑28 mortality. These findings do not support the exclusion... read more
Immunocompromised Patients with ARDS
Immunosuppression is frequent in patients with acute respiratory distress syndrome (ARDS), and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent... read more
Do We Know Enough to Recommend Corticosteroids in ARDS?
We read with interest the evidence-based recommendations for the use of prolonged corticosteroids in early moderate to severe acute respiratory distress syndrome (ARDS) published in Critical Care Medicine by the Corticosteroid... read more
Muscle Weakness and 5-Year Survival in ARDS Survivors
At hospital discharge, >1/3 of Acute Respiratory Distress Syndrome (ARDS) survivors had muscle weakness. Greater strength at discharge and throughout follow-up was associated with improved 5-year survival. In patients with... read more
The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research
TAPSE seemed to be the most popular index in the last 2–3 years. Many studies used combinations of indices but, apart from cor pulmonale, we could not find a consistent pattern of RV assessment and definition of RV dysfunction... read more
Genomics and Pharmacogenomics of Sepsis: So Close and Yet So Far
Sapru et al. show in this issue of Critical Care that variants of thrombomodulin and the endothelial protein C receptor, but not protein C, are associated with mortality and organ dysfunction (ventilation-free and organ failure-free... read more
Harrison’s Pulmonary and Critical Care Medicine
Featuring a superb compilation of chapters related to pulmonary and critical care topics, this concise, full-color clinical companion delivers the latest knowledge in the field backed by the scientific rigor and authority... read more
Evaluating Muscle Mass in Survivors of ARDS
In the first year after acute respiratory distress syndrome (ARDS), patients gained fat mass and maintained lean mass. We found no association of whole body percent lean mass with commonly hypothesized hospital risk factors.... read more
