Timing of the Onset of Acute Respiratory Distress Syndrome: A Population-Based Study

Shari, G; Kojičić, Marija; Li, Guangxi; Cartin‐Ceba, Rodrigo; Trillo-Alvarez, Cesar; Kashyap, Rahul; Dong, Yue; Poulose, Jaise T; Herasevich, Vitaly; Garza, Javier A Cabello; Gajic, Ognjen

doi:10.4187/respcare.00901

Cited by 51 publications

(41 citation statements)

References 37 publications

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“…4) (112). This fact, combined with the knowledge that ARDS almost always develops within a hospital setting (121) and, once established is refractory to treatment (82,87), collectively support the hypothesis that a preferred strategy should be to block the disease in an early stage rather than treat it once it develops. Indeed, Villar and Slutsky (133) recently commented that "ARDS is no longer a syndrome that must be treated, but is a syndrome that should be prevented.…”

Section: Ards Is a Disease That Progresses In Stagesmentioning

confidence: 66%

“…In addition, if mechanical ventilation with currently acceptable tidal volumes and pressures is applied during this period it can act as a second hit, exacerbating lung injury and resulting in a higher prevalence of established ARDS; however, if slight changes in VT or PEEP are applied early, then the incidence of established ARDS is reduced (16,45,48,49,51,52,66,75,119). These data, in addition to the fact that almost all ARDS develops in hospital settings (121), support the concept that preemptive application of a protective mechanical breath can block progressive ALI and reduce ARDS incidence. The next critical step is to ascertain 1) the precise mechanism of ventilator-induced damage to the pulmonary microenvironment (the alveoli and alveolar ducts); and 2) once the mechanism is known, identify the settings that would optimize the protective mechanical breath, thus preventing injury.…”

Section: What Do We Need To Know To Block Progressive Ali?mentioning

confidence: 99%

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Impact of mechanical ventilation on the pathophysiology of progressive acute lung injury

Nieman

Gatto

Habashi

2015

Journal of Applied Physiology

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Nieman GF, Gatto LA, Habashi NM. Impact of mechanical ventilation on the pathophysiology of progressive acute lung injury. J Appl Physiol 119: 1245-1261. First published October 15, 2015 doi:10.1152/japplphysiol.00659.2015The earliest description of what is now known as the acute respiratory distress syndrome (ARDS) was a highly lethal double pneumonia. Ashbaugh and colleagues (Ashbaugh DG, Bigelow DB, Petty TL, Levine BE Lancet 2: 319-323, 1967) correctly identified the disease as ARDS in 1967. Their initial study showing the positive effect of mechanical ventilation with positive end-expiratory pressure (PEEP) on ARDS mortality was dampened when it was discovered that improperly used mechanical ventilation can cause a secondary ventilator-induced lung injury (VILI), thereby greatly exacerbating ARDS mortality. This Synthesis Report will review the pathophysiology of ARDS and VILI from a mechanical stress-strain perspective. Although inflammation is also an important component of VILI pathology, it is secondary to the mechanical damage caused by excessive strain. The mechanical breath will be deconstructed to show that multiple parameters that comprise the breath-airway pressure, flows, volumes, and the duration during which they are applied to each breath-are critical to lung injury and protection. Specifically, the mechanisms by which a properly set mechanical breath can reduce the development of excessive fluid flux and pulmonary edema, which are a hallmark of ARDS pathology, are reviewed. Using our knowledge of how multiple parameters in the mechanical breath affect lung physiology, the optimal combination of pressures, volumes, flows, and durations that should offer maximum lung protection are postulated. acute lung injury; lung; pathophysiology ventilator; VILI THE POLIO EPIDEMIC OF 1916 inspired many treatment attempts including vitamin C therapy, hydrotherapy, and electrotherapy, but no effective therapy was found until Philip Drinker's group invented negative pressure mechanical ventilation-the iron lung. Their landmark paper, "The use of a new apparatus for the prolonged administration of artificial respiration: I. A fatal case of poliomyelitis," published in 1929, demonstrated the effective clinical use of this device (Fig. 1) (38). The concept of conversion from negative to positive pressure ventilation was based on technical advances that were made during World War II to deliver pressurized oxygen to high-altitude fighter and bomber pilots. Concomitant with these technologic advances in mechanical ventilation was the realization that what was originally thought to be a universally fatal form of double pneumonia was indeed a unique clinical entity that we now call the acute respiratory distress syndrome (ARDS). In a 1967 seminal paper published in The Lancet, Ashbaugh et al. (10) first identified and described ARDS as a collection of pathologic abnormalities that can be caused by many unrelated insults such as sepsis, hemorrhagic shock, pneumonia, and trauma to name a few. The disease and the ventil...

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Section: Ards Is a Disease That Progresses In Stagesmentioning

confidence: 66%

Section: What Do We Need To Know To Block Progressive Ali?mentioning

confidence: 99%

Impact of mechanical ventilation on the pathophysiology of progressive acute lung injury

Nieman

Gatto

Habashi

2015

Journal of Applied Physiology

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“…Many clinical risk factors are associated with the development of ARDS such as sepsis, shock, pneumonia, pancreatitis, aspiration, high-risk trauma and surgery, and multiple blood transfusions. A large multicentre observation study demonstrated that ARDS develops within a median of 2 days after hospital admission and also markedly increases in-hospital mortality in this patient population [14]. Many patients, therefore, develop ARDS during hospital admission because of a second-hit, but from potentially preventable exposures.…”

Section: Preventing Ardsmentioning

confidence: 99%

“…ARDS is not frequently present at the time of visiting the emergency room or hospital admission and it frequently occurs over a period of hours to days following the clinical insult [11][12][13][14]. Many clinical risk factors are associated with the development of ARDS such as sepsis, shock, pneumonia, pancreatitis, aspiration, high-risk trauma and surgery, and multiple blood transfusions.…”

Section: Preventing Ardsmentioning

confidence: 99%

Recent advances in mechanical ventilation in patients with acute respiratory distress syndrome

Rittayamai

Brochard

2015

Eur Respir Rev

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Acute respiratory distress syndrome (ARDS) is characterised by different degrees of severity and different stages. Understanding these differences can help to better adapt the ventilatory settings to protect the lung from ventilator-induced lung injury by reducing hyperinflation or keeping the lung open when it is possible. The same therapies may be useful and beneficial in certain forms of ARDS, and risky or harmful at other stages: this includes high positive end-expiratory pressure, allowance of spontaneous breathing activity or use of noninvasive ventilation. The severity of the disease is the primary indicator to individualise treatment. Monitoring tools such as oesophageal pressure or lung volume measurements may also help to set the ventilator. At an earlier stage, an adequate lung protective strategy may also help to prevent the development of ARDS. @ERSpublications The survival of patients on mechanical ventilation for ARDS can be improved by optimising ventilatory management http://ow.ly/Hapm3

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“…A group at the forefront of research on this topic published 2 papers of interest in 2011. 54,55 The first was a population-based observational study using an electronic surveillance tool to identify critically ill patients with ALI/ARDS. 54 Of those identified, 33% had ALI/ARDS present on admission, while 67% developed it while in the hospital within a median of 30 hours.…”

Section: Acute Lung Injury and Acute Respiratory Distress Syndromementioning

confidence: 99%

Respiratory Care Year in Review 2011: Long-Term Oxygen Therapy, Pulmonary Rehabilitation, Airway Management, Acute Lung Injury, Education, and Management

Dunne¹,

MacIntyre

Schmidt

et al. 2012

Respir Care

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SummaryFor the busy clinician, educator, or manager, it is becoming an increasing challenge to filter the literature to what is relevant to one's practice and then update one's practice based on the current evidence. The purpose of this paper is to review the recent literature related to long-term oxygen therapy, pulmonary rehabilitation, airway management, acute lung injury and acute respiratory distress syndrome, respiratory care education, and respiratory care management. These topics were chosen and reviewed in a manner that is most likely to have interest to the readers of RESPIRATORY CARE.

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Timing of the Onset of Acute Respiratory Distress Syndrome: A Population-Based Study

Cited by 51 publications

References 37 publications

Impact of mechanical ventilation on the pathophysiology of progressive acute lung injury

Impact of mechanical ventilation on the pathophysiology of progressive acute lung injury

Recent advances in mechanical ventilation in patients with acute respiratory distress syndrome

Respiratory Care Year in Review 2011: Long-Term Oxygen Therapy, Pulmonary Rehabilitation, Airway Management, Acute Lung Injury, Education, and Management

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