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Acute respiratory distress syndrome
Michael P Mortelliti1, Harold L Manning
1Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. philippe4@msn.com
American Family Physician
|May 23, 2002
Summary
Acute respiratory distress syndrome (ARDS) is severe lung injury causing breathing difficulties. Low-volume ventilation shows promise in reducing ARDS mortality, offering a new therapeutic approach.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Pathophysiology
Background:
- Acute respiratory distress syndrome (ARDS) is a severe clinical manifestation of acute lung injury.
- Characterized by diffuse bilateral pulmonary infiltrates, noncardiogenic pulmonary edema, refractory hypoxia, and decreased lung compliance.
Observation:
- ARDS frequently arises from sepsis, gastric aspiration, trauma, or transfusions.
- Pathophysiology involves endothelial/epithelial damage and increased pulmonary permeability.
- Early signs include tachypnea, hypoxia, and respiratory alkalosis, progressing to respiratory failure within 48 hours.
Findings:
- Experimental therapies like nitric oxide and surfactant have not improved ARDS mortality.
- Low-volume ventilation has demonstrated a decrease in ARDS-related mortality.
- Survivors often experience persistent mild to moderate lung function impairment.
Implications:
- Early identification and treatment of underlying causes are crucial for ARDS management.
- Aggressive supportive care is essential for patients with ARDS.
- Quality of life may be diminished in ARDS survivors compared to similar individuals without ARDS.