IN-HOSPITAL MORTALITY AND PLASMA BIOMARKERS IN ACUTE LUNG INJURY (ALI)/ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) IN THE ERA OF LUNG PROTECTIVE VENTILATION

CHEST Journal ◽  
2008 ◽  
Vol 134 (4) ◽  
pp. 88P
Author(s):  
Rodrigo Cartin-Ceba ◽  
Philippe Bauer ◽  
Murat Yilmaz ◽  
Roger Determann ◽  
Marcus Schultz ◽  
...  
2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Vipul J. Patel ◽  
Sreeja Biswas Roy ◽  
Hiren J. Mehta ◽  
Myungsoo Joo ◽  
Ruxana T. Sadikot

Introduction. Acute respiratory distress syndrome (ARDS) is a complex clinical syndrome characterized by acute inflammation, microvascular damage, and increased pulmonary vascular and epithelial permeability, frequently resulting in acute respiratory failure and death. Current best practice for ARDS involves “lung-protective ventilation,” which entails low tidal volumes and limiting the plateau pressures in mechanically ventilated patients. Although considerable progress has been made in understanding the pathogenesis of ARDS, little progress has been made in the development of specific therapies to combat injury and inflammation. Areas Covered. In recent years, several natural products have been studied in experimental models and have been shown to inhibit multiple inflammatory pathways associated with acute lung injury and ARDS at a molecular level. Because of the pleiotropic effects of these agents, many of them also activate antioxidant pathways through nuclear factor erythroid-related factor 2, thereby targeting multiple pathways. Several of these agents are prescribed for treatment of inflammatory conditions in the Asian subcontinent and have shown to be relatively safe. Expert Commentary. Here we review natural remedies shown to attenuate lung injury and inflammation in experimental models. Translational human studies in patients with ARDS may facilitate treatment of this devastating disease.


Author(s):  
Shahzad Shaefi ◽  
Aaron Mittel

Acute respiratory distress syndrome (ARDS), transfusion-related acute lung injury (TRALI), and transfusion-associated circulatory overload (TACO) are common conditions in critically ill patients that lead to pulmonary edema and hypoxemia. The nonhydrostatic edema characteristic of ARDS and TRALI is caused by an intense inflammatory response leading to increased microvascular permeability and alveolar injury. TACO is an acute hydrostatic edema temporally associated with events that precipitate lung injury. Lung-protective ventilation is the mainstay of therapy for ARDS and TRALI; optimizing gas exchange is the goal for all three. Prompt recognition is an important skill for perioperative practitioners.


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