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Lancet. 2016 Nov 12;388(10058):2416-2430. doi: 10.1016/S0140-6736(16)00578-X. Epub 2016 Apr 28.

Acute respiratory distress syndrome.

Author information

1
Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, Northern Ireland, UK.
2
Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, Northern Ireland, UK; Wellcome-Wolfson Institute for Experimental Medicine, Queen's University of Belfast, Belfast, Northern Ireland, UK. Electronic address: d.f.mcauley@qub.ac.uk.

Abstract

Acute respiratory distress syndrome presents as hypoxia and bilateral pulmonary infiltrates on chest imaging in the absence of heart failure sufficient to account for this clinical state. Management is largely supportive, and is focused on protective mechanical ventilation and the avoidance of fluid overload. Patients with severe hypoxaemia can be managed with early short-term use of neuromuscular blockade, prone position ventilation, or extracorporeal membrane oxygenation. The use of inhaled nitric oxide is rarely indicated and both β2 agonists and late corticosteroids should be avoided. Mortality remains at approximately 30%.

PMID:
27133972
DOI:
10.1016/S0140-6736(16)00578-X
[Indexed for MEDLINE]

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