Abstract
The first description of acute respiratory distress syndrome (ARDS) in adults appeared in 1967 and was characterized by dyspnea, hypoxemia, diffuse alveolar infiltrates, and reduced respiratory system compliance. ARDS and acute lung injury (ALI) syndrome have no specific treatment, only supportive care: treating the underlying cause, when possible, and using mechanical ventilation. Historically, mechanical ventilation applied normal/large tidal volumes and low levels of positive end-expiratory pressure (PEEP). Experimental data showed that a high-volume, high-pressure ventilation strategy may lead to lung lesions indistinguishable from ARDS. Subsequent randomized clinical trials showed improved survival using low tidal volumes (6 vs 12 mL/kg ideal body weight) and limiting plateau pressure to 30 cm H 2O, although the optimal level of PEEP remains controversial. Prone positioning should be reserved for severely ill patients. Inhaled nitric oxide, which is a pulmonary vasodilator with anti-inflammatory properties, is associated with limited improvement in oxygenation without improvement in survival.
| Original language | English |
|---|---|
| Pages (from-to) | 365-371 |
| Number of pages | 7 |
| Journal | Current Infectious Disease Reports |
| Volume | 11 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2009 |
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ASJC Scopus subject areas
- Infectious Diseases
Cite this
Respirator management of sepsis-related respiratory failure. / Chiumello, Davide; Cressoni, Massimo.
In: Current Infectious Disease Reports, Vol. 11, No. 5, 2009, p. 365-371.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Respirator management of sepsis-related respiratory failure
AU - Chiumello, Davide
AU - Cressoni, Massimo
PY - 2009
Y1 - 2009
N2 - The first description of acute respiratory distress syndrome (ARDS) in adults appeared in 1967 and was characterized by dyspnea, hypoxemia, diffuse alveolar infiltrates, and reduced respiratory system compliance. ARDS and acute lung injury (ALI) syndrome have no specific treatment, only supportive care: treating the underlying cause, when possible, and using mechanical ventilation. Historically, mechanical ventilation applied normal/large tidal volumes and low levels of positive end-expiratory pressure (PEEP). Experimental data showed that a high-volume, high-pressure ventilation strategy may lead to lung lesions indistinguishable from ARDS. Subsequent randomized clinical trials showed improved survival using low tidal volumes (6 vs 12 mL/kg ideal body weight) and limiting plateau pressure to 30 cm H 2O, although the optimal level of PEEP remains controversial. Prone positioning should be reserved for severely ill patients. Inhaled nitric oxide, which is a pulmonary vasodilator with anti-inflammatory properties, is associated with limited improvement in oxygenation without improvement in survival.
AB - The first description of acute respiratory distress syndrome (ARDS) in adults appeared in 1967 and was characterized by dyspnea, hypoxemia, diffuse alveolar infiltrates, and reduced respiratory system compliance. ARDS and acute lung injury (ALI) syndrome have no specific treatment, only supportive care: treating the underlying cause, when possible, and using mechanical ventilation. Historically, mechanical ventilation applied normal/large tidal volumes and low levels of positive end-expiratory pressure (PEEP). Experimental data showed that a high-volume, high-pressure ventilation strategy may lead to lung lesions indistinguishable from ARDS. Subsequent randomized clinical trials showed improved survival using low tidal volumes (6 vs 12 mL/kg ideal body weight) and limiting plateau pressure to 30 cm H 2O, although the optimal level of PEEP remains controversial. Prone positioning should be reserved for severely ill patients. Inhaled nitric oxide, which is a pulmonary vasodilator with anti-inflammatory properties, is associated with limited improvement in oxygenation without improvement in survival.
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UR - http://www.scopus.com/inward/citedby.url?scp=69249114698&partnerID=8YFLogxK
U2 - 10.1007/s11908-009-0052-0
DO - 10.1007/s11908-009-0052-0
M3 - Article
C2 - 19698280
AN - SCOPUS:69249114698
VL - 11
SP - 365
EP - 371
JO - Current Infectious Disease Reports
JF - Current Infectious Disease Reports
SN - 1523-3847
IS - 5
ER -