Early Treatment of Severe Acute Respiratory Distress Syndrome

Emerg Med Clin North Am. 2016 Feb;34(1):1-14. doi: 10.1016/j.emc.2015.08.001. Epub 2015 Nov 3.

Abstract

Acute respiratory distress syndrome (ARDS) is defined by acute diffuse inflammatory lung injury invoked by a variety of systemic or pulmonary insults. Despite medical progress in management, mortality remains 27% to 45%. Patients with ARDS should be managed with low tidal volume ventilation. Permissive hypercapnea is well tolerated. Conservative fluid strategy can reduce ventilator and hospital days in patients without shock. Prone positioning and neuromuscular blockers reduce mortality in some patients. Early management of ARDS is relevant to emergency medicine. Identifying ARDS patients who should be transferred to an extracorporeal membrane oxygenation center is an important task for emergency providers.

Keywords: Acute respiratory distress syndrome; Acute respiratory failure; Hypoxemia; Hypoxia; Severe ARDS.

Publication types

  • Review

MeSH terms

  • Airway Management / methods*
  • Emergency Treatment / methods*
  • Extracorporeal Membrane Oxygenation
  • Fluid Therapy / methods
  • Humans
  • Hypoxia / etiology
  • Hypoxia / therapy
  • Neuromuscular Blockade / methods
  • Respiration, Artificial / methods
  • Respiratory Distress Syndrome / diagnosis
  • Respiratory Distress Syndrome / physiopathology
  • Respiratory Distress Syndrome / therapy*