Clinics in chest medicine
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Clinics in chest medicine · Dec 2006
ReviewQuality of life, emotional abnormalities, and cognitive dysfunction in survivors of acute lung injury/acute respiratory distress syndrome.
This article provides a brief discussion of the recent literature linking quality-of-life impairment to physical dysfunction after acute lung injury/acute respiratory distress syndrome. Its main focus is a review of the current knowledge concerning cognitive and emotional outcomes after lung injury and their impact on long-term quality of life.
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Clinics in chest medicine · Dec 2006
ReviewThe role of CT-scan studies for the diagnosis and therapy of acute respiratory distress syndrome.
CT has provided new insights on the pathophysiology of acute respiratory distress syndrome (ARDS), demonstrating that ARDS does not affect the lung parenchyma homogeneously. These findings suggest that lung edema, as assessed by CT scan, should be included in the definition. ⋯ Ideally, tidal volume should be proportional to the portion of the lung open to ventilation, as assessed by CT scan, rather than to the body weight. CT assessment of lung recruitability seems to be a prerequisite for a rational setting of positive end-expiratory pressure.
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Clinics in chest medicine · Dec 2006
ReviewNewly recognized causes of acute lung injury: transfusion of blood products, severe acute respiratory syndrome, and avian influenza.
Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a clinical syndrome that has an ever-growing list of potential causes. The transfusion of blood products is often a life-saving therapy, but it can be associated with the development of ALI/ARDS. ⋯ Two infectious causes of ALI/ARDS, severe acute respiratory syndrome and H5N1 influenza, have recently emerged and have the potential for pandemic spread. This article discusses the clinical importance, pathogenesis, diagnosis, management, and prevention of these newly recognized causes of respiratory failure.
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Clinics in chest medicine · Dec 2006
ReviewAcute lung injury and the acute respiratory distress syndrome: challenges in clinical trial design.
Despite significant advances in the understanding of the complex pathophysiology, only a limited number of new treatments for acute lung injury (ALI) have emerged in the last 2 decades. This article discusses some of the challenges that remain in conducting clinical research in patients who have ALI and acute respiratory distress syndrome. ⋯ Delineating outcomes attributable to the lung injury will improve the power of studies to detect significant treatment effects. Future collaborative studies will be needed to investigate longer-term clinical outcomes.
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Clinics in chest medicine · Dec 2006
ReviewClinical epidemiology of acute lung injury and acute respiratory distress syndrome: incidence, diagnosis, and outcomes.
Acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) are clinical syndromes characterized by the sudden onset of severe hypoxemia and diffuse bilateral pulmonary infiltrates in the absence of left atrial hypertension. Although advances have been made in the understanding of the etiology, pathophysiology, and epidemiology of both entities, many questions remain regarding their incidence, diagnosis, and outcomes. This article reviews the currently used definition of ARDS and ALI, different studies that have advanced the understanding of the epidemiology and outcomes of these entities, and several diagnostic issues that are important for both clinicians and researchers.