Articles: respiratory-distress-syndrome.
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Critical care clinics · Oct 2021
ReviewThe Epidemiology of Acute Respiratory Distress Syndrome Before and After Coronavirus Disease 2019.
Acute respiratory distress syndrome (ARDS) is a heterogeneous syndrome of high morbidity and mortality with global impact. Current epidemiologic estimates are imprecise given differences in patient populations, risk factors, resources, and practice styles around the world. Despite improvement in supportive care which has improved mortality, effective targeted therapies remain elusive. ⋯ Intensive care unit rates of death have varied widely in studies to date because of a variety of patient and hospital-level factors. Despite some controversy, the best management of these patients is likely the same supportive measures shown to be effective in classical ARDS. Further epidemiologic studies are needed to help characterize the epidemiology of ARDS subphenotypes to facilitate identification of targeted therapies.
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Best Pract Res Clin Anaesthesiol · Oct 2021
ReviewCOVID-19-associated acute respiratory distress syndrome (CARDS): Current knowledge on pathophysiology and ICU treatment - A narrative review.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces coronavirus-19 disease (COVID-19) and is a major health concern. Following two SARS-CoV-2 pandemic "waves," intensive care unit (ICU) specialists are treating a large number of COVID19-associated acute respiratory distress syndrome (ARDS) patients. ⋯ In this article, we will discuss the underlying pulmonary pathophysiology and the clinical management of CARDS. In addition, we will outline current and potential future treatment approaches.
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Critical care clinics · Oct 2021
ReviewCOVID-19-Associated Acute Respiratory Distress Syndrome: Lessons from Tissues and Cells.
Reports examining lung histopathology in coronavirus disease 2019 (COVID-19) infection provide an essential body of information for clinicians and investigators. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-induced lung injury is complex, involving the airways, alveoli, and pulmonary vessels. ⋯ The biological and molecular mechanisms that drive this pattern of injury are unknown, and the relationship of SARS-CoV-2-induced DAD to physiologic alterations and clinical outcomes in COVID-19-associated acute respiratory distress syndrome is undefined. Additional histologic patterns that may be variant phenotypes have been reported.
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Pediatr Crit Care Me · Oct 2021
ReviewNeurally Adjusted Ventilator Assist in Infants With Acute Respiratory Failure: A Literature Scoping Review.
To map the evidence for neurally adjusted ventilatory assist strategies, outcome measures, and sedation practices in infants less than 12 months with acute respiratory failure using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidance. ⋯ This review highlights a lack of standardized strategies for neurally adjusted ventilatory assist ventilation and sedation practices among infants with acute respiratory failure. Studies were limited by small sample sizes and a lack of focus on specific patient groups. Robust studies are needed to provide evidence-based clinical recommendations for the use of neurally adjusted ventilatory assist in infants with acute respiratory failure.
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J Intensive Care Med · Oct 2021
Closed-Loop Versus Conventional Mechanical Ventilation in COVID-19 ARDS.
Lung-protective ventilation is key in bridging patients suffering from COVID-19 acute respiratory distress syndrome (ARDS) to recovery. However, resource and personnel limitations during pandemics complicate the implementation of lung-protective protocols. Automated ventilation modes may prove decisive in these settings enabling higher degrees of lung-protective ventilation than conventional modes. ⋯ Among critically ill, mechanically ventilated COVID-19 ARDS patients during an early highpoint of the pandemic, mechanical ventilation using a closed-loop mode was associated with a higher degree of lung-protective ventilation than was conventional mechanical ventilation.