Document Detail


Approaches to refractory hypoxemia in acute respiratory distress syndrome: current understanding, evidence, and debate.
MedLine Citation:
PMID:  22008398     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) cause substantial morbidity and mortality despite our improved understanding of lung injury, advancements in the application of lung-protective ventilation, and strategies to prevent ventilator-induced lung injury. Severe refractory hypoxemia may develop in a subset of patients with severe ARDS. We review several approaches referred to as "rescue" therapies for severe hypoxemia, including lung-recruitment maneuvers, ventilation modes, prone positioning, inhaled vasodilator therapy, and the use of extracorporeal membrane oxygenation. Each shows evidence for improving oxygenation, though each has associated risks, and no single therapy has proven superior in the management of severe hypoxemia. Importantly, increased survival with these strategies has not been clearly established.
Authors:
Stephen R Collins; Randal S Blank
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Respiratory care     Volume:  56     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1573-82     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
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