A 50 años de la descripción del síndrome de insuficiencia respiratoria aguda

Abstract

In 1967, Ashbaugh et al. published in the Lancet the description of a new entity, for which they coined the name "adult respiratory distress syndrome". On that article, they thoroughly described 12 patients who had respiratory distress with bilateral pulmonary infiltrates and oxygen therapy-refractory hypoxemia. For its management, emphasis was made on the importance of intubation and mechanical ventilation with positive end-expiratory pressure. At 50 years of its first publication, great advances on the knowledge of this condition have been achieved, which has influenced on patient management and survival. To celebrate this 50th anniversary, the National Academy of Medicine of Mexico organized a symposium with the purpose to spread the knowledge about this condition, recognize the researchers who made the original description and those who over the course of 50 years of history have contributed to its better understanding. The symposium addressed the topics of lung-kidney interaction, molecular bases of the disease and therapeutic advances.

Lesión pulmonar autoinflingida por el paciente en la Unidad de Cuidados Intensivos

“…Para abordar este punto, un ensayo internacional en curso (PRotective VENTilation) es probar los efectos de Vt 4 a 6 mL/kg frente a 9 a 10 mL/kg de peso predicho en una población de pacientes ventilados sin SDRA. 20 Al mantener programación de ventilación mecánica en parámetros de protección pulmonar, estaríamos evitando el VILI, las recomendaciones apuntan a realizar un destete ventilatorio lo más rápido posible, siempre y www.medigraphic.org.mx cuando las condiciones para el mismo estén presentes; en esta línea, la valoración de la ventana neurológica y la valoración de la ventilación espontánea, parecieran ser ideales en todos los pacientes en la UCI.…”

Acute Respiratory Distress Syndrome in Children: Duration of Ventilation and Mortality

“…These cases are related to a multiorgan failure involving systemic endothelial and pulmonary capillary injury, which makes clinical evolution unfavorable with increased mortality [22]. Some authors pose mortality above or equal to 50%, despite all treatment strategies [6,19,23].…”

“…The treatment is part of the identification, control and treatment of the trigger and in the mechanical artificial ventilation, the latter with the aim of preserving the arterial saturation of oxygen and avoid complications by the increase airway pressures [5,6].…”

“…Reports from the United States, Australia, Europe and New Zealand indicate that the incidence of ARDS in the pediatric population is 2 to 12.8 per 100000 patients per year and mortality is found between 27% and 35% [5,7]. Other authors, in different regions incidence of 0.8% to 4.4% and mortality above 50% [6,8]. A 10-year job at a UCIP Cuba, report or 3.6% with overall mortality of 36.7% A retrospective study was conducted on patients admitted to 15 UCIP in 13 provinces of Cuba, which were diagnosed with SDRA, according to the consensus of acute lung damage [4] in the period from January 2016 to December 2018.…”

Serum interleukin-18

“…Acute respiratory distress syndrome (ARDS) is a medical condition with critical disorders or critically wounded patients characterized by widespread inflammation in the lungs. [1] It is well known that ARDS is closely linked with severe pulmonary [2] or systemic infection, [3] after trauma, multiple blood transfusions, severe burns, [4] severe inflammation of the pancreas. [5] Additionally, the partial cases of ARDS were associated with large volumes of fluid used during posttrauma resuscitation.…”