Tag: ARDS

Fluid Management in Acute Respiratory Distress Syndrome

In this video, Dr. Stacey Valentine discusses fluid management in acute respiratory distress syndrome (ARDS), including the evidence supporting fluid-restrictive strategies. Both acute lung injury and its more severe form,... read more

High-frequency Oscillatory Ventilation: Still a Role?

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... read more

Outcomes of Patients Presenting with Mild ARDS

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... read more

Are “Sniffer” Systems Effective in Detecting ARDS?

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... read more

The Benefit of Lung-Protective Ventilation in the ED

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... read more

Prospective Assessment of the Feasibility of a Trial of Low Tidal Volume Ventilation for Patients with Acute Respiratory Failure

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... read more

Association of Driving Pressure With Mortality Among Ventilated Patients With ARDS

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... read more

Identifying associations between diabetes and ARDS in patients with AHRF

Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of... read more

Angiotensin converting enzyme defects in shock: implications for future therapy

Patients who develop vasodilatory shock, particularly when caused by an inflammatory condition like sepsis or pancreatitis, have evidence of significant endothelial injury as manifested by coagulation disorders and increased... read more

Electrical Impedance Tomography in ARDS

Acute respiratory distress syndrome (ARDS) is a clinical entity that acutely affects the lung parenchyma, and is characterized by diffuse alveolar damage and increased pulmonary vascular permeability. Currently, computed... read more

Initial Trophic vs Full Enteral Feeding in Patients With Acute Lung Injury

In patients with acute lung injury, compared with full enteral feeding, a strategy of initial trophic enteral feeding for up to 6 days did not improve ventilator-free days, 60-day mortality, or infectious complications but... read more

Implementing a bedside assessment of respiratory mechanics in patients with ARDS

Implementing a systematic respiratory mechanics test leads to frequent individual adaptations of ventilator settings and allows improvement in oxygenation indexes and reduction of the risk of overdistention at the same time.... read more

Adjunct and Rescue Therapies for Refractory Hypoxemia

Prone position, inhaled nitric oxide, high frequency oscillation, extra corporeal life support. The mortality of severe acute respiratory distress syndrome (ARDS), defined with a PaO2/FiO2 ratio of 100 mmHg... read more

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