{"id":19877,"date":"2024-08-01T13:00:12","date_gmt":"2024-08-01T18:00:12","guid":{"rendered":"https:\/\/turnmedical.com\/?p=19877"},"modified":"2024-08-01T13:20:45","modified_gmt":"2024-08-01T18:20:45","slug":"acute-respiratory-distress-syndrome","status":"publish","type":"post","link":"https:\/\/turnmedical.com\/acute-respiratory-distress-syndrome\/","title":{"rendered":"The Devastating Acute Respiratory Distress Syndrome"},"content":{"rendered":"\t\t
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The Devastating Acute Respiratory Distress Syndrome<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\"ADRS<\/p>

By Allison Varnum<\/span><\/em><\/p>

\u201cBe mindful when it comes to your words. A string of some that don\u2019t mean much to you, may stick with someone else for a lifetime.\u201d<\/em> \u2013Rachel Wolchin<\/em><\/span><\/p>

Acute respiratory distress syndrome (ARDS) is a string of words that can prompt critical care clinicians into immediate and emergent action. It is a string of words to some families that brings memories of helplessness and grief.<\/span><\/p>

ARDS is a devastating clinical syndrome that advances rapidly and has a mortality rate of over 40%1<\/span><\/span><\/span>\u00a0with 10% of intensive care patients developing ARDS3<\/span><\/span><\/span>. The phrase \u201cacute respiratory distress syndrome\u201d (ARDS) was first introduced in 1967 to describe 12 patients with a distinct clinical presentation that was different from 272 other ventilated patients. The distinguishing characteristics were \u201catelectasis, vascular congestion and hemorrhage, severe pulmonary edema, and hyaline membranes2<\/span><\/span><\/span>.\u201d Simply put, ARDS causes difficulty breathing or respiratory failure because the lungs fill with fluid depriving organs of oxygen leading to multi system organ failure1<\/span><\/span><\/span>.<\/span><\/p>

Unfortunately, there are no known drugs to cure ARDS. Caring for ARDS patients relies on supportive measures for symptoms and treating the underlying cause of the lung injury. Supportive care consists of lung protective ventilation, prone positioning, and neuromuscular blockers3<\/span><\/span><\/span>. Salvage therapies include ECMO, inhaled nitric oxide (iNO), and corticosteroids4<\/span><\/span><\/span>. Even with advancements in ECMO over the last 15 years, ARDS still has a high mortality rate despite ECMO therapy5<\/span><\/span><\/span>. Inhaled nitric oxide has been shown to improve arterial oxygenation in patients with ARDS, but there was no evidence that iNO results in a better overall outcome of ARDS6<\/span><\/span><\/span>. While corticosteroids are effective in treating pneumonia, there has not been enough research to define the dosage needed to consistently treat ARDS7<\/span><\/span><\/span>.<\/span><\/p>

In 2013, the New England Journal of Medicine published the PROSEVA study which was the first randomized-controlled trial to show that prone positioning reduces mortality in patients with ARDS. When ARDS patients are placed in the prone position early after diagnosis and they are proned for a prolonged period, mortality is significantly decreased8<\/span><\/span><\/span>. For further explanation of the PROSEVA study, visit our blog post here<\/a><\/strong>. <\/span><\/p>

Pronova-O2TM<\/span><\/span> Automated Prone Therapy System provides a safe and efficient method to place critically ill patients in the prone position. Patients come in all shapes and sizes, and the Pronova-O2<\/span>\u00a0offers protection for caregivers placing the patient in the prone position. Manual prone positioning requires multiple providers and causes physical strain; however, using the Pronova-O2<\/span>\u00a0only requires 1-2 caregivers and takes the manual labor out of the equation. For additional information on automated prone positioning, please visit turnmedical.com or call 855-ASK-TURN<\/strong>.<\/span><\/p><\/div><\/div>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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References<\/span><\/p>

  1. Battaglini, D., Fazzini, B., Silva, P.L., Cruz, F.F., Ball, L., Robba, C., Rocco, P.R.M., and Pelosi, P. (2023). Challenges in ARDS definition, management, and identification of effective personalized therapies. Journal of Clinical Medicine, 12(4), 1381. https:\/\/doi.org\/10.3390\/jcm12041381<\/span><\/li>
  2. Ranieri, V.M., Rubenfeld, G., and Slutsky, A.S. (2022). Rethinking acute respiratory distress syndrome after covid-19: If a \u201cbetter\u201d definition is the answer, what is the question? American Journal of Respiratory and Critical Care Medicine, 207(3):255-260.<\/span> https:\/\/doi.org\/10.1164\/rccm.202206-1048CP<\/span><\/a><\/li>
  3. Ramji, H.F., Hafiz, M., Altaq, H.H., Hussain, S. T., and Chaudry, F. (2023). Acute respiratory distress syndrome; A review of recent updates and a glance into the future. Diagnostics, 13(9), 1528.<\/span> https:\/\/doi.org\/10.3390\/diagnostics13091528<\/span><\/a><\/li>
  4. Papazian, L., Aubron, C., Brochard, L., Chiche, J.D., Combes, A., Dreyfuss, D., Forel, J.M., Guerin, C., Jaber, S., Mekontso-Dessap, A., Mercat, A., Richard, J.C., Roux, D., Vieillard-Baron, A., and Faure, H. (2019). Formal guidelines: management of acute respiratory distress syndrome. Annals of Intensive Care, 9(69).<\/span> https:\/\/doi.org\/10.1186\/s13613-019-0540-9<\/span><\/a><\/li>
  5. Friedrichson, B., Mutlak, H., Zacharowski, K., and Piekarski, F. (2021). Insight into ECMO, mortality and ARDS: a nationwide analysis of 45,647 ECMO runs. Critical Care 25(38). https:\/\/doi.org\/10.1186\/s13054-021-03463-2<\/span><\/li>
  6. Lotz, C., Muellenbach, R.M., Meybohm, P., Mutlak, H., Lepper, P.M., Rolfes, C.B., Pievandi, A., Stumpner, J., Kredel, M., Kranke, P., Torje, I., and Reyher, C. (2020). Effects of inhaled nitric oxide in COVID-19-induced ARDS \u2013 is it worthwhile? Acta Anaesthesiologica Scandinavica, 65(5), 629-632. https:\/\/doi.org\/10.1111\/aas.13757<\/span><\/li>
  7. Kuperminc, E., Heming, N., Carlos, M., and Annane, D. (2023). Corticosteroids in ARDS. Journal of internal medicine, 12(9), 3340. https:\/\/doi.org\/10.3390\/jcm12093340<\/span><\/li>
  8. Guerin, C., Reignier, J., Richard, J.C., Bueret, P., Gacouin, A., Boulain, T., Mercier, E., et al. (2013). Prone positioning in severe acute respiratory distress syndrome. New England Journal of Medicine, 368(23). DOI: 10.1056\/NEJMoa1214103<\/span><\/li><\/ol>



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