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2015, Number 1

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Rev Hosp Jua Mex 2015; 82 (1)

Síndrome de insuficiencia respiratoria aguda

Hernández-López GD, Zamora GSE, Gorordo SLA, García-Román MTA, Jiménez-Ruiz A, Tercero GBI

Language: Spanish
References: 42
Page:
PDF size: 227.31 Kb.


ABSTRACT

The acute respiratory distress syndrome (ARDS) is an important cause of acute respiratory failure that is often associated with multiple organ failure. Is characterized by pulmonary edema and refractory hypoxemia. Several clinical disorders can precipitate ARDS, including pneumonia, sepsis, aspiration of gastric contents, and major trauma. Based on both experimental and clinical studies, progress has been made in understanding the mechanisms responsible for the pathogenesis and the resolution of lung injury, including the contribution of environmental and genetic factors. Lung edema is likely the single pathogenic factor more relevant for ARDS severity and outcome. Fluid overload must be avoided. Several monitoring techniques are available to reach this target. Recently, the new definition of ARDS has been published, and this definition suggested severity-oriented respiratory treatment by introducing three levels of severity according to PaO2/FiO2 and positive end-expiratory pressure. Lung-protective ventilation is still the key of better outcome in ARDS. Improve survival has been achieved with the use of lung-protective ventilation, short-term use of neuromuscular blockade at initial stage of mechanical ventilation, prone position in severe ARDS and extracorporeal membrane oxygenation showed beneficial efficacy in randomized trials. Therefore, early recognition of ARDS risk factors and the avoidance of aggravating factors during the patient’s hospital stay can help decrease its development. Future progress will depend on developing novel therapeutics that can facilitate and enhance lung repair.


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