Pharmacotherapy of acute respiratory distress syndrome.
To date, the only therapeutic option that has convincingly been shown to decrease mortality in acute respiratory distress syndrome (ARDS) has been to use a lung-protective strategy that minimises the iatrogenic consequences of providing adequate life support through the use of mechanical ventilation. In terms of the pharmacological options for ARDS, no single drug or treatment has been shown to be the magic bullet in this disease. The search for novel therapies and pharmacological agents is active and relentless. Important pathophysiological areas of focus are preventative therapy, supportive care and treatment of the underlying inflammatory process. In this paper we will review current and experimental approaches to the management of ARDS. In addition, the pathophysiological basis for their putative modes of action, the current state of the literature and the potential for future clinical development will be discussed.
dos Santos
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Department of Critical Care Medicine, St. Michael's Hospital, Toronto, Ontario, Canada.
Chant
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Slutsky
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D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D002465:Cell Movement / Q000187:drug effects; D051523:Fibroblast Growth Factor 7; D005346:Fibroblast Growth Factors / Q000627:therapeutic use; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism; D009504:Neutrophils / Q000187:drug effects; D018384:Oxidative Stress / Q000187:drug effects; D012123:Pulmonary Ventilation / Q000187:drug effects; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D014665:Vasodilator Agents / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000975:Antioxidants; C496453:FGF7 protein, human; D014665:Vasodilator Agents; D051523:Fibroblast Growth Factor 7; D016753:Interleukin-10; D016179:Granulocyte Colony-Stimulating Factor; D005346:Fibroblast Growth Factors