Abstract Acute Respiratory Distress Syndrome Research Articles

A case of acute respiratory distress syndrome treated with surfactant and low dose methylprednisolone

Acute respiratory distress syndrome (ARDS) is the pulmonary manifestation of a systemic inflammatory process that is triggered by various events. Because of the various cytokines and vasoactive peptides secreted by the damaged endothelium, the vascular permeability is increased and this results in the migration of neutrophils, eosinophils, macrophages and other inflammatory cells, and also the leakage of protein-rich fluid. Edema consequently develops in the alveolus, and respiratory distress and hypoxia are then induced. Various attempts have recently been reported as conservative treatments for ARDS, but most of these treatments are at the experimental stage, and the mortality still reaches up to 40-60% 1-3) .

Acute Respiratory Distress Syndrome after Early Successful Primary Percutaneous Coronary Intervention Therapy in Acute Myocardial Infarction: A Case Report

Acute respiratory distress syndrome (ARDS) is characterized by acute-onset dyspnea, diffuse bilateral pulmonary infiltration, low pulmonary capillary wedge pressure (PCWP), and an arterial oxygen tension/inspired oxygen fraction (PaO2/FiO2) ratio of less than 200 mmHg. Acute myocardial infarction (AMI), whether complicated by circulatory arrest, cardiogenic shock, and hypotension or not, was reported as an etiologic factor in the development of ARDS in the prethrombolytic era. In the thrombolytic era, two cases of AMI complicated with ARDS have been reported. ARDS in these two patients resulted from anaphylactic reaction to the thrombolytic agent and not from the hemodynamic consequences of AMI. Development of ARDS during the AMI period has not been reported after early successful primary percutaneous coronary intervention (PCI). Herein, we report a 61-year-old male patient with persistent chest pain who was diagnosed with Killip II anterior ST-segment elevation AMI. He was treated successfully with primary PCI 2.5 hours after the onset of chest pain. Unfortunately, on the third hospital day, acute-onset dyspnea (respiratory rate, 33 beats/min), fever (38.5 degrees C), leukocytosis (white blood cell count, 18,360/microL), and diffuse bilateral pulmonary infiltration were noted. ARDS was diagnosed from the low PCWP (8 mmHg) and a PaO2/FiO2 of less than 200 mmHg (160 mmHg). No usual causes of ARDS such as infection, aspiration, trauma, shock, or drug reactions were noted. We assumed that, in this particular patient, the systemic inflammatory response syndrome frequently induced by AMI might have caused this episode of ARDS. This may imply that AMI itself is a possible etiology of ARDS.

Kinetic therapy positively influences oxygenation in patients with ALI/ARDS

Acute respiratory distress syndrome (ARDS) is a fulminant form of respiratory failure, with diverse aetiology, despite technological advances in intensive care medicine; mortality rates remain 50-70%. Costs associated with the management of patients in intensive therapy unit (ITU) are very high; therefore, the requirement for those working in critical care to provide evidence-based practice is mandatory. One area of investigation is that kinetic therapy improves pulmonary complications in critically ill patients by positively influencing oxygenation and gaseous exchange. Whilst kinetic therapy does appear to be an effective therapy in ITU, there are inconsistencies in reported findings, and thus, clearly a need for further research into this innovative therapy to maximize its potential.

The pathophysiology of acute respiratory distress syndrome.

Acute respiratory distress syndrome (ARDS) is a heterogeneous process that results in diffuse alveolar damage. It is associated with a variety of causative factors that can be grouped into two general categories, those associated with direct lung injury through the airways and those associated with indirect lung injury through the blood stream. Regardless of whether injury originates within or outside the lung, a systematic inflammatory response is triggered. This article reviews some of the physiologic alterations associated with ARDS before focusing on the derangement in the cellular environment.

Hemodynamic profile and vasoactive drugs in acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS) is characterized by diffuse inflammatory response in the lungs with refractory hypoxemia. The maintenance of hemodynamic stability is a key point for tissue perfusion in this syndrome.

Prospective study to evaluate the kind of prone position concerning nursing, pulmonary outcome and material and personnel resources

Acute Respiratory Distress Syndrome (ARDS) is one of the most common, potentially lethal disease processes encountered in critical care with extremely high mortality of about 60%. Researchers have found that a significant improvement in gas exchange often occurs when ARDS patients are turned from the supine to the prone position. But there are a lot of difficulties in nursing these patients in dependence of the kind of kinetic therapy. So the major goal is, to find out the best kind of kinetic therapy. The available study is designed by physicians and nurses. Besides the question of patients benefit concerning the gas exchange the handling, the acceptance of the nurses and economical consequences are proofed.

Diagnosis of acute respiratory distress syndrome and differentiation from ventilator-associated pneumonia

Acute respiratory distress syndrome (ARDS) remains a significant cause of morbidity and mortality in surgical intensive care unit patients. A relatively predictable sequence of pathophysiologic events occur in the lung, which involve inflammatory mediators and neutrophils. The characteristic radiographic findings of ARDS may mimic ventilator-associated pneumonia (VAP), making the diagnosis of VAP difficult. The standard clinical criteria of fever, leukocytosis, purulent sputum, and infiltrate on chest radiograph are not specific for pneumonia in the surgical patient. The use of bronchoscopy with bronchoalveolar lavage and quantitative cultures can differentiate local and systemic inflammatory response to injury or blood loss from invasive bacterial pneumonia. Basing antibiotic therapy solely on the results of quantitative cultures is safe, because quantitative cultures identify VAP in less than half the patients with clinical evidence of pneumonia. Empiric therapy should be based on the microbiology of the intensive care unit rather than the results of the Gram stain.

What is Acute Respiratory Distress Syndrome?

Acute respiratory distress syndrome (ARDS) is a form of acute lung injury which usually occurs within 24 hours of a major illness or injury. Unfortunately a clear definition of ARDS does not presently exist, and the variability in the diagnostic criteria may impact on the results of clinical trials for ARDS and our understanding of the epidemiology and pathogenesis of this syndrome. In this article the history of ARDS is reviewed and a few of the definitions that have evolved over wtime are explored in depth. In addition, several controversies with these existing defiitions are discussed.

Acute respiratory distress syndrome: an overview.

Acute Respiratory Distress Syndrome (ARDS) is a fulminant form of respiratory failure which has diverse aetiology. Although the pathophysiology of the disease is understood in some depth today, much is still elusive and, despite technological advances in intensive care medicine, mortality rates remain high. This article focuses on the key areas of: the inflammatory processes in ARDS, the altered pulmonary physiology, and finally the outcomes, treatments and the need for future research. A knowledge of these aspects is useful to intensive care nurses.

Klinische Aspekte des akuten Lungenversagens des Erwachsenen (ARDS)

Acute respiratory distress syndrome (ARDS) is rare but beset with a high mortality rate. In recent years, however, a trend towards higher survival rates has been observed. High inspiratory oxygen concentrations, large tidal volumes, and high peak inspiratory airway pressures applied during mechanical ventilation have been identified as harmful to the lung and can contribute to the progression of ARDS. This had led to reconsideration of the sequelae of ventilatory therapy. Mechanical ventilation and other adjunctive strategies in ARDS have changed from the conventional approach aiming at normalisation of physiological ventilatory parameters to an elaborated approach that intends to protect the ventilated lung, prevent oxygen toxicity, recruit the infiltrated atelectatic and consolidated lung and reduce the anatomical and alveolar dead space. This new approach consists of various forms of pressure-controlled mechanical ventilation with PEEP and permissive hypercapnia, body position changes, and inhalation of nitric oxide. Should these procedures fail to improve impaired gas exchange, extracorporeal membrane oxygenation is an additional therapeutic option. None of these therapeutic procedures, however, has been tested against traditional standard treatment in a classical randomised controlled trial. The following review focuses on the latest insights into the pathophysiology, diagnosis, and treatment of ARDS.