title: Optimal Strategies for Severe Acute Respiratory Distress Syndrome.
abstract: Acute respiratory distress syndrome (ARDS) occurs in more than 10% of intensive care unit admissions and in nearly 25% of ventilated patients. Mortality remains high at 40%, and, for patients who survive, recovery continues for months or even years. Early recognition and minimizing further lung injury remain essential to successful management of severe ARDS. Advanced treatment strategies, which complement lung protective ventilation, include short-term neuromuscular blockade, prone positioning, and extracorporeal membrane oxygenation. Alternative ventilator strategies include high-frequency ventilation and airway pressure release ventilation. This article reviews these options in patients with severe ARDS.
authors.affiliation: Division of Trauma, Surgical Critical Care & Emergency Surgery, The Perelman School of Medicine at the University of Pennsylvania, 51 North 39th Street, MOB Suite 120, Philadelphia, PA 19104, USA. Electronic address: jeremy.cannon@uphs.upenn.edu.
authors.forename: Jeremy W
authors.initials: JW
authors.lastname: Cannon
authors.affiliation: Department of Anesthesiology and Critical Care, The Perelman School of Medicine at the University of Pennsylvania, 51 North 39th Street, Philadelphia, PA 19104, USA.
authors.forename: Jacob T
authors.initials: JT
authors.lastname: Gutsche
authors.affiliation: Division of Pulmonary, Allergy, & Critical Care Medicine, Columbia University Medical Center, 622 West 168 Street, PH 8 East, Room 101, New York, NY 10032, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Brodie
mesh_terms: D003422:Critical Care / Q000379:methods; D015199:Extracorporeal Membrane Oxygenation; D006801:Humans; D012121:Respiration, Artificial / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000628:therapy*
keywords: Acute respiratory distress syndrome; Extracorporeal membrane oxygenation; High-frequency oscillatory ventilation; Lung protective ventilation; Neuromuscular blockade; Physical conditioning; Prone positioning; Pulmonary vasodilators