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Med Intensiva. 2017 Dec;41(9):550-558. doi: 10.1016/j.medin.2016.12.012. Epub 2017 Feb 24.

Mechanical ventilation in acute respiratory distress syndrome: The open lung revisited.

[Article in English, Spanish]

Author information

1
Unidad de Gestión Clínica de Medicina Intensiva, Hospital Valle del Nalón, Langreo, Spain.
2
Unidad de Cuidados Intensivos Cardiológicos, Hospital Universitario Central de Asturias, Oviedo, Spain.
3
Servicio de Medicina Intensiva, Hospital Universitario Central de Asturias, Oviedo, Spain.
4
Unidad de Cuidados Intensivos Cardiológicos, Hospital Universitario Central de Asturias, Oviedo, Spain; Departamento de Biología Funcional, Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Spain. Electronic address: Guillermo.muniz@sespa.es.

Abstract

Acute respiratory distress syndrome (ARDS) is still related to high mortality and morbidity rates. Most patients with ARDS will require ventilatory support. This treatment has a direct impact upon patient outcome and is associated to major side effects. In this regard, ventilator-associated lung injury (VALI) is the main concern when this technique is used. The ultimate mechanisms of VALI and its management are under constant evolution. The present review describes the classical mechanisms of VALI and how they have evolved with recent findings from physiopathological and clinical studies, with the aim of analyzing the clinical implications derived from them. Lastly, a series of knowledge-based recommendations are proposed that can be helpful for the ventilator assisted management of ARDS at the patient bedside.

KEYWORDS:

Acute respiratory distress syndrome; Lesión pulmonar asociada a ventilador; Mechanical ventilation; Síndrome de dificultad respiratoria aguda; Ventilación mecánica; Ventilator-associated lung injury

PMID:
28238441
DOI:
10.1016/j.medin.2016.12.012
[Indexed for MEDLINE]
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