TY  - CHAP
M1  - Book, Section
TI  - The Acute Respiratory Distress Syndrome
A1  - Sottile, Peter D.
A1  - Schmidt, Eric P.
A1  - Mould, Kara J.
A2  - Schmidt, Gregory A.
A2  - Kress, John P.
A2  - Douglas, Ivor S.
PY  - 2023
T2  - Hall, Schmidt and Wood’s Principles of Critical Care, 5<sup>th</sup> Edition
AB  - KEY  POINTSAcute  respiratory  distress  syndrome  (ARDS)  is  a  common  critical  illness  that  is  diagnosed  by  a  constellation  of  clinical  findings,  representing  an  end  consequence  of  numerous  different  pathophysiological  pathways.The  diagnosis  of  ARDS  is  often  delayed  or  inaccurate,  frustrating  attempts  to  implement  effective  therapeutic  and  supportive  care.Therapeutics  targeting  ARDS  pathogenesis  have  largely  failed,  likely  due  to  the  false  homogenization  of  ARDS  as  a  single  disease  state.The  major  goals  of  mechanical  ventilation  in  ARDS  are  to  ensure  adequate  oxygenation  and  ventilation  while  minimizing  ventilator-induced  lung  injury.Lung-protective  ventilation  consists  of  lower-tidal  volume  (6  mL/kg  PBW)  and  low-pressure  (<30  cm  H2O  plateau  pressure)  ventilation.Prone  positioning  in  moderate-to-severe  ARDS  is  underutilized,  improves  mortality,  reduces  VILI,  and  improves  oxygenation.Driving  pressure  may  be  a  reasonable  measure  to  personalize  the  tidal  volume  and  pressure  targets  identified  in  larger  randomized  control  trials  to  minimize  VILI.Corticosteroids  decrease  mortality  in  ARDS  due  to  COVID-19.Conservative  fluid  management  strategies  and  minimization  of  sedative  medications  likely  reduce  the  duration  of  mechanical  ventilation  for  patients  with  ARDS.Inhaled  pulmonary  vasodilators  and  extracorporeal  membrane  oxygenation  are  potential  salvage  therapies  for  patients  with  refractory  hypoxemia.  
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2024/10/13
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1201803291
ER  -