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ARDS

Recognition and optimizing treatment of acute respiratory distress syndrome (ARDS)

ARDS is a syndrome that appears to be under recognized, undertreated, and associated with a high mortality rate. ARDS is a progressive process with an early treatment window that can be exploited. [1]

Topics

ARDS – the clinical challenge


Acute respiratory distress syndrome (ARDS) is a serious lung condition that causes low blood oxygen. The incidence of ARDS varies widely; in the US it has been estimated between 78.9 and 81.0 per 100,000 population, while in Europe the incidence has been estimated to lie between 7.2 and 25.5 per 100,000 population.[2] The global burden of ARDS has been estimated to be in excess of 3 million patients per year.[3]
Mortality for severe ARDS was reported at 46.1% in an observational study that included 459 ICUs across 50 countries.1 In the US, ARDS affects approximately 200,000 people and results in 74,500 deaths annually.[4]

Where are the causes?


ARDS is a syndrome associated with many conditions and most patients are already hospitalized at the time of diagnosis. According to the Berlin definition of ARDS, different clinical sings can help you identify patient condition status, from mild to severe.
A sample treatment algorithm for adults with ARDS begins typically with optimization of lung protective ventilation, and progresses to more invasive interventions based on the condition of the patient. Treatment plans must be individualized to the cause and available interventions at the treating facility. [5]

The COVID-19 pandemic has seen a surge of patients with acute respiratory distress syndrome (ARDS) in intensive care units across the globe. [6]

Related articles

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"Without access to an Edi signal you can’t give patients the best possible respiratory care."

Using the electrical activity of the diaphragm (Edi) to evaluate ICU patients’ need for respiratory support is a valuable and often superior complement to standard monitoring parameter, according to senior respiratory consultant Sten Borgström.

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Mitigating the risk of harm during the transition from controlled to assisted mechanical ventilation
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Mitigating the risk of harm during the transition from controlled to assisted mechanical ventilation

Monitoring the strength of the patient's breathing effort, titrating the sedation, and selecting the correct mode of ventilation is vital when transitioning from controlled to assisted ventilation.

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Dr Torben Andersen, Vejle Hospital
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Low sedation ventilation strategy

The key to having less sedated and actively participating patients is to be able to meet their breathing needs. To try and sustain their natural breathing effort as much as possible.

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Covid-19 & PiCCO
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The Italian experience: a practical advice

Professor Salvatore Grasso, Head of the Department of Anesthesia and Resuscitation at the Faculty of Medicine and Surgery of the University of Bari Aldo Moro Polyclinic, tells his story about the worst health care situation in Italy. Watch the video and learn what he experienced firsthand during the treatment of severely ill patients, at this time, infected by an unknown virus.

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Sepsis treatment
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Hemodynamic Management in Sepsis Patients

Everyone is at risk of developing sepsis. Globally, up to 50 million people are affected by sepsis, every year. Every 2.8 seconds, one patient dies from sepsis and associated complications. Often, it can be prevented by vaccination, clean water and hygiene, safe childbirth, and preventing hospital-acquired infections (HAIs). However, sepsis is often underdiagnosed, especially at an early stage where treatments are more successful.

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The impact of diaphragm injury on ventilation outcomes
  • Intensive Care

Monitor diaphragm and improve mechanical ventilation

Respiratory support is a lifesaving intervention in the ICU, but without the right balance it also increases the risk of detrimental outcomes.1,2 This is when diaphragm monitoring can help, because it is a marker of outcomes such as hospital mortality and prolonged weaning. Furthermore, it can help you make more informed therapy decisions throughout respiratory treatment.

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Alle referanser

  1. Sadowitz B, Jain S, Kollisch-Singule M, et al. Preemptive mechanical ventilation can block progressive acute lung injury. World J Crit Care Med. 2016;5(1):74-82. Published 2016 Feb 4. doi:10.5492/wjccm.v5.i1.74

  2. PubMed
    Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries.
    Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, Gattinoni L, van Haren F, Larsson A, McAuley DF, Ranieri M, Rubenfeld G, Thompson BT, Wrigge H, Slutsky AS, Pesenti A, LUNG SAFE Investigators, ESICM Trials Group
    JAMA. 2016 Feb;315(8):788-800.

  3. Health Topic "ARDS" on National Heart, Lung, and Blood Institute

  4. ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012 Jun

  5. Fan E, Brodie D, Slutsky AS. Acute Respiratory Distress Syndrome: Advances in Diagnosis and Treatment. JAMA. 2018 Feb 20;319(7):698-710.

  6. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30304-0/fulltext

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