title: Preemptive mechanical ventilation can block progressive acute lung injury.
abstract: Mortality from acute respiratory distress syndrome (ARDS) remains unacceptable, approaching 45% in certain high-risk patient populations. Treating fulminant ARDS is currently relegated to supportive care measures only. Thus, the best treatment for ARDS may lie with preventing this syndrome from ever occurring. Clinical studies were examined to determine why ARDS has remained resistant to treatment over the past several decades. In addition, both basic science and clinical studies were examined to determine the impact that early, protective mechanical ventilation may have on preventing the development of ARDS in at-risk patients. Fulminant ARDS is highly resistant to both pharmacologic treatment and methods of mechanical ventilation. However, ARDS is a progressive disease with an early treatment window that can be exploited. In particular, protective mechanical ventilation initiated before the onset of lung injury can prevent the progression to ARDS. Airway pressure release ventilation (APRV) is a novel mechanical ventilation strategy for delivering a protective breath that has been shown to block progressive acute lung injury (ALI) and prevent ALI from progressing to ARDS. ARDS mortality currently remains as high as 45% in some studies. As ARDS is a progressive disease, the key to treatment lies with preventing the disease from ever occurring while it remains subclinical. Early protective mechanical ventilation with APRV appears to offer substantial benefit in this regard and may be the prophylactic treatment of choice for preventing ARDS.
authors: Benjamin Sadowitz, the Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL 33613, United States.
authors: Benjamin
authors: B
authors: Sadowitz
authors: Benjamin Sadowitz, the Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL 33613, United States.
authors: Sumeet
authors: S
authors: Jain
authors: Benjamin Sadowitz, the Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL 33613, United States.
authors: Michaela
authors: M
authors: Kollisch-Singule
authors: Benjamin Sadowitz, the Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL 33613, United States.
authors: Joshua
authors: J
authors: Satalin
authors: Benjamin Sadowitz, the Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL 33613, United States.
authors: Penny
authors: P
authors: Andrews
authors: Benjamin Sadowitz, the Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL 33613, United States.
authors: Nader
authors: N
authors: Habashi
authors: Benjamin Sadowitz, the Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL 33613, United States.
authors: Louis A
authors: LA
authors: Gatto
authors: Benjamin Sadowitz, the Southeastern Center for Digestive Disorders and Pancreatic Cancer, Advanced Minimally Invasive and Robotic Surgery, Florida Hospital Tampa, Tampa, FL 33613, United States.
authors: Gary
authors: G
authors: Nieman
keywords: Acute lung injury; Acute respiratory distress syndrome; Airway pressure release ventilation; Mechanical ventilation