Personalized Respiratory Support in ARDS: A Physiology-to-Bedside Review

Area of Science:

• Critical Care Medicine
• Pulmonology
• Respiratory Physiology

Background:

• Acute respiratory distress syndrome (ARDS) is a significant global cause of mortality and disability.
• Current treatments focus on respiratory support, but improper management can worsen lung injury.
• ARDS presents with high heterogeneity, necessitating individualized care strategies.

Purpose of the Study:

• To review noninvasive and invasive respiratory support strategies for ARDS.
• To discuss the role of ARDS sub-phenotyping in guiding personalized respiratory support.
• To highlight how physiological assessment can optimize patient management and outcomes.

Main Methods:

• Narrative review of current literature on ARDS management.
• Discussion of physiological principles guiding respiratory support.
• Exploration of tools for identifying ARDS sub-phenotypes.

Main Results:

• Noninvasive and invasive respiratory support are crucial for ARDS management.
• Physiology-based approaches are essential for tailoring support to patient needs.
• Identifying ARDS sub-phenotypes aids in personalized treatment strategies.

Conclusions:

• Personalized respiratory support, guided by physiological assessment and sub-phenotyping, is key to optimizing ARDS care.
• Tailoring interventions can mitigate risks like patient self-inflicted lung injury and ventilator-induced lung injury.
• Further integration of sub-phenotyping into clinical practice may improve patient outcomes in ARDS.