title: Acute respiratory distress syndrome: evaluation and management.
abstract: Acute respiratory distress syndrome (ARDS) is a life-threatening condition that affects patients admitted in the Intensive Care Units (ICUs) under mechanical ventilation. ARDS is a process of non-hydrostatic pulmonary edema and hypoxemia associated with a variety of conditions, resulting in a direct (e.g., pneumonia) or indirect (e.g., sepsis) lung injury and is associated with a significant morbidity and mortality. A large body of clinical and basic research has focused in ventilatory strategies and novel pharmacological therapies but, nowadays, treatment is mainly supportive. Mechanical ventilation is the hallmark of the management of these patients. In the last decades, the recognition that mechanical ventilation can contribute to harming the lung has changed the goals of this therapy and has driven research to focus in ventilatory strategies that mitigate lung injury. This review emphasizes clinical aspects in the evaluation and management of ARDS in the ICUs and updates the latest advances in these therapies.
authors.affiliation: CIBER de Enfermedades Respiratorias, Intensive Care Department, Hospital Universitario de Getafe, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Cortés
authors.forename: O
authors.initials: O
authors.lastname: Peñuelas
authors.forename: A
authors.initials: A
authors.lastname: Esteban
mesh_terms: D055371:Acute Lung Injury / Q000209:etiology / Q000517:prevention & control; D000328:Adult; D000818:Animals; D002986:Clinical Trials as Topic; D003422:Critical Care / Q000379:methods*; D019468:Disease Management; D004353:Drug Evaluation, Preclinical; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000628:therapy; D008168:Lung / Q000503:physiopathology / Q000648:ultrastructure; D015201:Meta-Analysis as Topic; D015337:Multicenter Studies as Topic; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality; D018579:Patient Selection; D011175:Positive-Pressure Respiration / Q000379:methods; D016684:Prone Position; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods*; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D013990:Tidal Volume
chemical_list: D011663:Pulmonary Surfactants