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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]

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All references

  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