About: The standard of care of patients with ARDS: ventilatory settings and rescue therapies for refractory hypoxemia

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About: The standard of care of patients with ARDS: ventilatory settings and rescue therapies for refractory hypoxemia Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	The standard of care of patients with ARDS: ventilatory settings and rescue therapies for refractory hypoxemia
Creator	Bein, Thomas Mehta, Sangeeta Brondani, Anita Deja, Maria Grasso, Salvatore Guerin, Claude Moerer, Onnen Quintel, Michael
Source	Medline; PMC
abstract	PURPOSE: Severe ARDS is often associated with refractory hypoxemia, and early identification and treatment of hypoxemia is mandatory. For the management of severe ARDS ventilator settings, positioning therapy, infection control, and supportive measures are essential to improve survival. METHODS AND RESULTS: A precise definition of life-threating hypoxemia is not identified. Typical clinical determinations are: arterial partial pressure of oxygen < 60 mmHg and/or arterial oxygenation < 88 % and/or the ratio of PaO(2)/FIO(2) < 100. For mechanical ventilation specific settings are recommended: limitation of tidal volume (6 ml/kg predicted body weight), adequate high PEEP (>12 cmH(2)O), a recruitment manoeuvre in special situations, and a ‘balanced’ respiratory rate (20-30/min). Individual bedside methods to guide PEEP/recruitment (e.g., transpulmonary pressure) are not (yet) available. Prone positioning [early (≤ 48 hrs after onset of severe ARDS) and prolonged (repetition of 16-hr-sessions)] improves survival. An advanced infection management/control includes early diagnosis of bacterial, atypical, viral and fungal specimen (blood culture, bronchoalveolar lavage), and of infection sources by CT scan, followed by administration of broad-spectrum anti-infectives. Neuromuscular blockage (Cisatracurium ≤ 48 hrs after onset of ARDS), as well as an adequate sedation strategy (score guided) is an important supportive therapy. A negative fluid balance is associated with improved lung function and the use of hemofiltration might be indicated for specific indications. CONCLUSIONS: A specific standard of care is required for the management of severe ARDS with refractory hypoxemia.
has issue date	2016-04-04(xsd:dateTime)
bibo:doi	10.1007/s00134-016-4325-4
bibo:pmid	27040102
has license	cc-by-nc
sha1sum (hex)	d1d5731887f0cd5d6aa82905be71655febb4d8b5
schema:url	https://doi.org/10.1007/s00134-016-4325-4
resource representing a document's title	The standard of care of patients with ARDS: ventilatory settings and rescue therapies for refractory hypoxemia
has PubMed Central identifier	PMC4828494
has PubMed identifier	27040102
schema:publication	Intensive Care Med
resource representing a document's body	covid:d1d5731887f0cd5d6aa82905be71655febb4d8b5#body_text
is schema:about of	named entity 'MEASURES' named entity 'MANAGEMENT' named entity 'SURVIVAL' named entity 'ASSOCIATED WITH' named entity 'PURPOSE' named entity 'SUPPORTIVE' named entity 'REFRACTORY' named entity 'refractory' named entity 'refractory' named entity 'DEFINITION' named entity 'HYPOXEMIA' named entity 'POSITIONING THERAPY' named entity 'ESSENTIAL' named entity 'EARLY IDENTIFICATION' named entity 'INFECTION CONTROL' named entity 'SETTINGS' named entity 'VENTILATOR' named entity 'INTRODUCTION' named entity 'STANDARD OF CARE' named entity 'THERAPIES' named entity 'SETTINGS' named entity 'RESCUE' named entity 'CARE OF' named entity 'PATIENTS' named entity 'ARDS' named entity 'MONITORING' named entity 'TREATMENT' named entity 'REFRACTORY' named entity 'HYPOXEMIA' named entity 'MANDATORY' covid:arg/d1d5731887f0cd5d6aa82905be71655febb4d8b5 named entity 'Purpose' named entity 'ARDS' named entity 'measures' named entity 'ARDS' named entity 'hypoxemia' named entity 'infection control' named entity 'standard of care' named entity 'refractory' named entity '1.02' named entity 'ARDS' named entity 'alveolar' named entity 'superinfection' named entity 'oxygen delivery' named entity 'ARDS' named entity 'supine position' named entity 'lungs' named entity 'tissue hypoxia' named entity 'hypoxemia' named entity 'ARDS' named entity 'ICU' named entity 'alveolar' named entity 'hypercapnia' named entity 'organ dysfunction' named entity 'methylprednisolone' named entity 'ARDS' named entity 'hypoxemic' named entity 'VALI' named entity 'ARDS' named entity 'broadspectrum' named entity 'Electrical impedance tomography' named entity 'control group' named entity 'PCR' named entity 'acute respiratory distress syndrome' named entity 'tissue damage' named entity 'cisatracurium' named entity 'supine position' named entity 'oxygen' named entity 'hemodynamic' named entity 'prone position' named entity 'Prone position' named entity 'blood volume' named entity 'significant difference' named entity 'nitric oxide'

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