Acute respiratory distress syndrome, the critical care paradigm: What we learned and what we forgot

Luciano Gattinoni, Eleonora Carlesso, Franco Valenza, Davide Chiumello, Maria Luisa Caspani

Research output: Contribution to journalArticle

Abstract

In the last several years, we definitely learned that the acute respiratory distress syndrome lung is small, nonhomogeneous, and that mechanical ventilation in this baby lung may cause physical damage as well as inflammatory reaction. The clinical benefit of the gentle lung treatment, based on a decrease of global/regional stress and strain into the lung, has been finally proved. However, we forgot the importance of lung perfusion and its distribution in this syndrome and, besides a low tidal volume, we still do not know how to handle the other variables of mechanical ventilation. Measurements of variables as transpulmonary pressure and end expiratory lung volume, for a rational setting of mechanical ventilation, should be introduced in routine clinical practice.

Original languageEnglish
Pages (from-to)272-278
Number of pages7
JournalCurrent Opinion in Critical Care
Volume10
Issue number4
DOIs
Publication statusPublished - Aug 2004

Keywords

  • ALI/ARDS
  • Gas exchange
  • Lung mechanics
  • Randomized trials
  • Ventilator-induced lung injury

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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