Abstract
Mechanical ventilation is the standard life-support technique for patients with severe acute respiratory failure. However, some patients develop persistent and refractory hypoxemia because their lungs are so severely damaged that they are unable to respond to the application of high inspired oxygen concentration and high levels of positive end-expiratory pressure. In this article, we review current knowledge on managing persistent hypoxemia in patients with injured lungs.
Highlights
Introduction and contextAcute hypoxemic respiratory failure due to acute respiratory distress syndrome (ARDS) is one of the most severe forms of acute lung injury
Caused by direct or indirect insults to the lungs, it is characterized clinically by hypoxemia that does not respond to the administration of high inspiratory concentrations of oxygen (FiO ) and by the presence of bilateral pulmonary infiltrates on chest imaging due to high-permeability pulmonary edema[1]
The aim of this review is to summarize the current knowledge on a number of techniques that have been shown to improve oxygenation and outcome in ARDS patients with persistent hypoxemia
Summary
What is the acute respiratory distress syndrome? Respir Care. 2011; 56(10): 1539–45. 2. What is the acute respiratory distress syndrome? 2. Ashbaugh DG, Bigelow DB, Petty TL, et al.: Acute respiratory distress in adults. 4. Villar J, Blanco J, del Campo R, et al.: Assessment of PaO2/FiO2 for stratification of patients with moderate and severe acute respiratory distress syndrome. 5. Villar J, Slutsky AS: Is acute respiratory distress syndrome an iatrogenic disease? 7. Phoenix SI, Paravastu S, Columb M, et al.: Does a higher positive end expiratory pressure decrease mortality in acute respiratory distress syndrome? Papazian L, Forel J, Gacouin A, et al.: Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med. 2010; 363(12): 1107–16.
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