Lung protective mechanical ventilation and rescue therapy for severe hypoxemia

Abstract

Acute respiratory distress syndrome (ARDS) is a clinical syndrome of non-cardiogenic pulmonary oedema associated with bilateral pulmonary infiltrates, stiff lungs and refractory hypoxemia. Despite our improved understanding of lung injury, advancements in application of lung protective ventilation to prevent ventilatory induced lung injury (VILI), lung injury persist or progresses in some patients, leading to refractory hypoxemia. We review several ?rescue? strategies for severe hypoxemia, including lung recruitment maneuver, prone positioning, inhaled vazodilatators, and extracorporal membrane oxygenation.