Lung Epithelial Protein Expression and the Use of Volatile Anesthetics in Acute Respiratory Distress Syndrome.

Eric P Decker,Audrey A Vasauskas

doi:10.7759/cureus.10196

Abstract

Acute respiratory distress syndrome (ARDS) is a potentially fatal lung injury that can present with divergent underlying cause across cases. Current treatment options are limited by an incomplete understanding of the disease sequelae, undefined unifying pathology, and lack of reliable diagnostic tools. ARDS is defined as respiratory failure not caused by fluid overload or cardiac failure within one week of a known clinical insult with bilateral opacities on chest imaging, and diagnosis is based on these parameters. Increased understanding of the inflammatory cascade associated with ARDS progression shows promise for identifying potential diagnostic biomarkers and additional treatment options. Here, we review recent studies that point to the unifying inflammatory element(s) of the disease process and the use of agents that decrease inflammation as potentially powerful treatments for ARDS patients.

Highlights

We review the recent studies which have sought to address this gap in knowledge with the majority showing Acute respiratory distress syndrome (ARDS) results in increases to primarily inflammatory markers with upregulation of genes normally seen in an inflammatory response
Increases have been seen with IL-6, IL-1, histones, and receptor for advanced glycation end-products (RAGE) levels all of which have clinical significance and present the possibility of expanded treatment options [2]
The clinical implications of this are massive as we are currently limited to treating the underlying cause of ARDS and offering supportive therapies to those with this potentially fatal syndrome

Summary

Introduction

Acute respiratory distress syndrome (ARDS) is an incompletely understood process describing lifethreatening lung injury with a variety of underlying causes. It is defined as respiratory failure not caused by fluid overload or cardiac failure, within one week of a known clinical insult, with bilateral opacities visible on chest imaging [1]. Increases have been seen with IL-6, IL-1, histones, and receptor for advanced glycation end-products (RAGE) levels all of which have clinical significance and present the possibility of expanded treatment options [2]. Identification of further biomarkers of ARDS and more specific therapies for its treatment may result in a decreased reliance on ventilators, shortened intubation time, and decreased mortality

Methodology

Summary and future work

Disclosures

Siegel M: Acute respiratory distress syndrome