Acute respiratory distress syndrome.
Angiopoietin-2
/ analysis
Antigens, CD
/ physiology
Biomarkers
/ analysis
Cadherins
/ physiology
Carbon Dioxide
/ analysis
Glucocorticoids
/ therapeutic use
High-Frequency Ventilation
/ methods
Humans
Interleukin-8
/ analysis
Positive-Pressure Respiration
/ methods
Quality of Life
/ psychology
Radiography
/ methods
Respiration, Artificial
/ adverse effects
Respiratory Distress Syndrome
/ diagnosis
Vasodilator Agents
/ therapeutic use
Ventilator-Induced Lung Injury
/ complications
von Willebrand Factor
/ analysis
Journal
Nature reviews. Disease primers
ISSN: 2056-676X
Titre abrégé: Nat Rev Dis Primers
Pays: England
ID NLM: 101672103
Informations de publication
Date de publication:
14 03 2019
14 03 2019
Historique:
entrez:
16
3
2019
pubmed:
16
3
2019
medline:
17
9
2019
Statut:
epublish
Résumé
The acute respiratory distress syndrome (ARDS) is a common cause of respiratory failure in critically ill patients and is defined by the acute onset of noncardiogenic pulmonary oedema, hypoxaemia and the need for mechanical ventilation. ARDS occurs most often in the setting of pneumonia, sepsis, aspiration of gastric contents or severe trauma and is present in ~10% of all patients in intensive care units worldwide. Despite some improvements, mortality remains high at 30-40% in most studies. Pathological specimens from patients with ARDS frequently reveal diffuse alveolar damage, and laboratory studies have demonstrated both alveolar epithelial and lung endothelial injury, resulting in accumulation of protein-rich inflammatory oedematous fluid in the alveolar space. Diagnosis is based on consensus syndromic criteria, with modifications for under-resourced settings and in paediatric patients. Treatment focuses on lung-protective ventilation; no specific pharmacotherapies have been identified. Long-term outcomes of patients with ARDS are increasingly recognized as important research targets, as many patients survive ARDS only to have ongoing functional and/or psychological sequelae. Future directions include efforts to facilitate earlier recognition of ARDS, identifying responsive subsets of patients and ongoing efforts to understand fundamental mechanisms of lung injury to design specific treatments.
Identifiants
pubmed: 30872586
doi: 10.1038/s41572-019-0069-0
pii: 10.1038/s41572-019-0069-0
pmc: PMC6709677
mid: NIHMS1042397
doi:
Substances chimiques
ANGPT2 protein, human
0
Angiopoietin-2
0
Antigens, CD
0
Biomarkers
0
Cadherins
0
Glucocorticoids
0
Interleukin-8
0
Vasodilator Agents
0
cadherin 5
0
von Willebrand Factor
0
Carbon Dioxide
142M471B3J
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
18Subventions
Organisme : NHLBI NIH HHS
ID : R21 HL145506
Pays : United States
Organisme : NHLBI NIH HHS
ID : R35 HL140026
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL130541
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL044525
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL077671
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL131608
Pays : United States
Organisme : NICHD NIH HHS
ID : R21 HD095228
Pays : United States
Organisme : NHLBI NIH HHS
ID : R37 HL044525
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL134828
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL133489
Pays : United States
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