Acute Respiratory Distress Syndrome: A Case Report and Review on Diagnosis and Novel Interventions in Management

Abstract

Acute respiratory distress syndrome is a type of acute diffuse lung injury, frequently brought on by sepsis, trauma, and severe pulmonary infections and continues to be one of the major causes of morbidity and mortality in critically ill patients, despite the constantly involving advancements. The management strategies have constantly evolved with a wide array of ventilation strategies, conservative fluid management, neuromuscular blockade. As we move into the post pandemic Era, the mortality rate due to ARDS continues to remain high hence improving patient outcomes is the primary goal of the various treatment approaches. The two most effective techniques are still prone ventilation and lung protection ventilation. In this report we aim to present the case of a 30-year old female who has undergone left lobectomy in childhood and presents to the clinic with palpitations, fever, shortness of breath and spasmodic cough with phlegm. The workup included chest Xray, CT scan, arterial blood gas with electrolytes, echocardiography and urinanalysis. Based on clinical and imaging findings, the diagnosis of acute respiratory distress syndrome was made. Against the background of intensive treatment, the patient’s condition improved to some extent, with positive dynamics. Lung protective ventilation, prone ventilation, high frequency oscillatory ventilation among many other novel interventions and futuristic direction of ARDS with mesenchymal stromal cells and Ulinastatin, a urinary glycoprotein and protease inhibitor provides a ray of hope in the management of this acute condition. Keywords: Acute respiratory distress syndrome; hypoplasia; lung ventilation; prone ventilation; mesenchymal stem cells; ulinastatin