Pharmacotherapy of acute lung injury and the acute respiratory distress syndrome

J Intensive Care Med. May-Jun 2006;21(3):119-43. doi: 10.1177/0885066606287045.

Abstract

Acute lung injury and the acute respiratory distress syndrome are common syndromes with a high mortality rate that affect both medical and surgical patients. Better understanding of the pathophysiology of acute lung injury and the acute respiratory distress syndrome and advances in supportive care and mechanical ventilation have led to improved clinical outcomes since the syndrome was first described in 1967. Although several promising pharmacological therapies, including surfactant, nitric oxide, glucocorticoids and lysofylline, have been studied in patients with acute lung injury and the acute respiratory distress syndrome, none of these pharmacological treatments reduced mortality. This article provides an overview of pharmacological therapies of acute lung injury and the acute respiratory distress syndrome tested in clinical trials and current recommendations for their use as well as a discussion of potential future pharmacological therapies including beta(2)-adrenergic agonist therapy, keratinocyte growth factor, and activated protein C.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Administration, Inhalation
  • Adrenergic beta-Agonists / therapeutic use
  • Anticoagulants / therapeutic use
  • Antioxidants / therapeutic use
  • Fibroblast Growth Factor 7 / therapeutic use
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Pulmonary Surfactants / therapeutic use
  • Respiration, Artificial / methods
  • Respiratory Distress Syndrome / drug therapy*
  • Respiratory Distress Syndrome / physiopathology
  • Respiratory Distress Syndrome / therapy
  • Vasodilator Agents / administration & dosage
  • Vasodilator Agents / therapeutic use

Substances

  • Adrenergic beta-Agonists
  • Anticoagulants
  • Antioxidants
  • Glucocorticoids
  • Pulmonary Surfactants
  • Vasodilator Agents
  • Fibroblast Growth Factor 7