By Lena M. Napolitano MD, Krishnan Raghavendran MD
This factor of severe Care Clinics will specialize in serious Acute respiration misery Syndrome and working with it within the ICU. issues will contain: demanding situations and Successes in ARDS Research;Mechanical air flow with Lung protecting suggestions: What works?; Gene remedy for ALI/ARDS;High Frequency Oscillatory air flow in ALI/ARDS;Prone positioning remedy in ARDS;Recovery and long term end result in ARDS; and Experimental versions and emergeing hypotheses for ALI and ARDS
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Additional resources for ALI and ARDS: Challenges and Advances, An Issue of Critical Care Clinics (The Clinics: Internal Medicine)
Chest 2008;133(1):62–71. 455 456 Blank & Napolitano 91. Siddiki H, Kojicic M, Li G, et al. Bedside quantification of dead-space fraction using routine clinical data in patients with acute lung injury: secondary analysis of two prospective trials. Crit Care 2010;14(4):R141. 92. Bull TM, Clark B, McFann K, et al. Pulmonary vascular dysfunction is associated with poor outcomes in patients with acute lung injury. Am J Respir Crit Care Med 2010;182(9):1123–8. 93. Mangialardi RJ, Martin GS, Bernard GR, et al.
However, 2 other clinical trials raised questions about this hypothesis, and the use of smaller tidal volumes is not always easy to do. The ARMA study was a randomized, controlled multicenter 2 Â 2 factorial study consisting of a drug treatment (ketoconazole vs placebo) and a ventilation strategy (6 mL/kg tidal volume vs 12 mL/kg tidal volume). The ventilator arm of the protocol was designed to compare different ventilator strategies (Fig. 2) and their effect on mortality and morbidity. The lower tidal volume 461 462 Thompson & Bernard Fig.
44. Shorr AF, Abbott KC, Agadoa LY. Acute respiratory distress syndrome after kidney transplantation: epidemiology, risk factors, and outcomes. Crit Care Med 2003;31(5):1325–30. 45. Kahn JM, Caldwell EC, Deem S, et al. Acute lung injury in patients with subarachnoid hemorrhage: incidence, risk factors, and outcome. Crit Care Med 2006; 34(1):196–202. 46. Rhee CK, Kang JY, Kim YH, et al. Risk factors for acute respiratory distress syndrome during neutropenia recovery in patients with hematologic malignancies.
ALI and ARDS: Challenges and Advances, An Issue of Critical Care Clinics (The Clinics: Internal Medicine) by Lena M. Napolitano MD, Krishnan Raghavendran MD