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Severe respiratory failure: advanced treatment options.
Mark R Hemmila1, Lena M Napolitano
1Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA.
Critical Care Medicine
|August 19, 2006
Summary
Advanced treatments for severe respiratory failure, including acute lung injury and acute respiratory distress syndrome, improve patient outcomes. This review covers lung protective ventilation and pharmacologic strategies for better hypoxemia management.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Respiratory Physiology
Background:
- Severe respiratory failure, encompassing acute lung injury and acute respiratory distress syndrome, presents significant mortality and morbidity across all age groups.
- Understanding lung pathophysiology is crucial for managing respiratory failure.
Purpose of the Study:
- To review laboratory and clinical data supporting advanced treatments for severe respiratory failure.
- To outline future directions in the management of severe respiratory failure.
Main Methods:
- Comprehensive literature search of MEDLINE/PubMed.
- Inclusion of primary and review articles relevant to severe respiratory failure treatment.
Main Results:
- Advances in lung protective ventilation strategies, including low-tidal volume ventilation, permissive hypercapnia, open lung approach, recruitment maneuvers, airway pressure release ventilation, high-frequency oscillatory ventilation, prone positioning, and extracorporeal life support.
- Review of pharmacologic strategies such as corticosteroids, surfactant, and nitric oxide for treating severe respiratory failure.
Conclusions:
- An incremental approach to managing severe hypoxemia is essential.
- Implementation of evidence-based strategies is key for effective treatment of severe respiratory failure.