[Acute respiratory distress syndrome].
Acute respiratory distress syndrome (ARDS) is a non cardiogenic pulmonary edema that results from several pulmonary or extrapulmonary insults. ARDS respiratory manifestations, in fact, represent the expression of a complex and diffuse inflammatory process involving other organs. Mechanical ventilation is considered to be a cornerstone of treatment. Alterations in respiratory mechanic (decrease in compliance) mainly due to the reduction in non-atelectasis lung volume, are responsible for the high airway pressure observed during mechanical ventilation. Since mechanical ventilation, itself, could promote lung injury, a ventilatory strategy combining both, low volumes to limit distension and positive end expiratory pressure to recruit atelectasis may be beneficial. This hypothesis has been recently confirmed in a study involving more than 800 patients, demonstrating that a simple ventilatory strategy based on recent physiological knowledge may affect ARDS outcome.
Richard
Jean-Christophe
JC
Service de réanimation médicale Hôpital Charles Nicolle 76031 Rouen. jrichard@invivo.edu
D000328:Adult; D003422:Critical Care / Q000379:methods; D006801:Humans; D007249:Inflammation; D008170:Lung Compliance; D011379:Prognosis; D012121:Respiration, Artificial / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D015656:Respiratory Mechanics; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome