The acute respiratory distress syndrome

Article Abstract:

Artificial lung surfactant may not be effective in reducing mortality rates from acute respiratory distress syndrome (ARDS), but conventional treatments have reduced death rates considerably and new treatments are being evaluated. ARDS is caused by an increase in permeability of the lining of the lungs that results in the accumulation of fluid in the lungs which compromises their function. Artificial lung surfactant has been used successfully in neonatal respiratory distress syndrome (RDS) so researchers have tested it in ARDS. A 1996 study found no reduction in death rates in ARDS patients who were given synthetic surfactant. However, only 5% of the solution may have been delivered to the lungs and the surfactant used contains no protein that could stabilize the lungs. It is also possible that ARDS and neonatal RDS are different conditions. Beta-adrenergic agonists and direct installation of surfactant via bronchoscopy are promising treatments. Conventional treatment has reduced mortality rates from 60% to 40% over the past two decades.

Editorial, Lung surfactant, Synthetic, Synthetic lung surfactants

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The acute respiratory distress syndrome

Article Abstract:

The acute respiratory distress syndrome (ARDS) is defined as acute lung injury with an impaired ability to exchange oxygen and a buildup of fluid in the air spaces. Laboratory tests used to evaluate patients with suspected ARDS include chest x-rays; computed tomography; measurements of gas exchange, of membrane barrier function and of extravascular water; bronchoalveolar lavage; hemodynamic monitoring; and scoring systems such as the Acute Physiology and Chronic Health Evaluation (APACHE) III. Non-drug treatments for ARDS may consist of mechanical ventilation, repositioning of the patient, and fluid management. Recommended pharmacologic therapies may include corticosteroids 7 to 14 days after the onset of ARDS, antibiotics, and possibly ketoconazole, inhaled nitric oxide, pentoxifylline, and antiendotoxin and anticytokine therapy. Most patients who die of ARDS will die within two weeks of onset, and the overall death rate may be 50%.

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The prevention of ventilator-associated pneumonia

Article Abstract:

Many deaths can be prevented among patients on a ventilator by preventing ventilator-associated pneumonia. This infection sometimes occurs in patients on a ventilator. It usually happens because bacteria growing in the gastrointestinal tract are inhaled into the lungs. It can be prevented by using infection control procedures, elevating the patient's upper body, avoiding feeding tubes and giving small amounts of food, and properly maintaining the ventilator circuits. Antibiotics, antiseptic mouth washes, immune globulin and anti-ulcer drugs may also be effective. Some vaccines may prevent bacteria from growing in the gastrointestinal tract and lungs.

Prevention, Complications and side effects, Artificial respiration, Mechanical ventilation, Pneumonia, Ventilators, Ventilators (Medical equipment)

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