Acute Respiratory Distress Syndrome; A Review of Recent Updates and a Glance into the Future
Abstract
:1. Introduction
- (1)
- Timing: “Within one week of a known clinical insult or new or worsening respiratory symptoms”
- (2)
- Chest Imaging (X-ray or Computed Tomography): “Bilateral opacities—not fully explained by effusions, lobar/lung collapse, or nodules”.
- (3)
- Origin of Edema: “Respiratory failure not fully explained by cardiac failure or fluid overload” with “objective assessment (e.g., echocardiography) to exclude hydrostatic edema if no risk factor present”.
- (4)
- Oxygenation:
- Mild: 200 mm Hg < PaO2/FIO2 ≤ 300 mm Hg with PEEP or CPAP ≥ 5 cm H2O
- Moderate: 100 mm Hg < PaO2/FIO2 ≤ 200 mm Hg with PEEP ≥ 5 cm H2O
- Severe: PaO2/FIO2 ≤ 100 mm Hg with PEEP ≥ 5 cm H2O
2. Pathophysiology
3. Current Management Strategies
4. Pharmacotherapy in ARDS; Recent Trials
4.1. Beta Agonists
4.2. Sivelestat
4.3. Simvastatin
4.4. Vitamin D
5. Mesenchymal Stromal Cells
6. Gut–Lung Interaction in ARDS
7. Metabolomics and Future Directions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Hyperinflammatory Phenotype Compared to Hypo-Inflammatory Phenotype |
---|
High levels of IL-6, IL-8, sTNFr-1 |
Lower serum bicarbonate levels |
Low protein C levels |
More profound hypotension |
Higher mortality |
Less ventilator-free days |
Lower mortality with higher PEEP |
Improved mortality with fluid conservative strategy |
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Ramji, H.F.; Hafiz, M.; Altaq, H.H.; Hussain, S.T.; Chaudry, F. Acute Respiratory Distress Syndrome; A Review of Recent Updates and a Glance into the Future. Diagnostics 2023, 13, 1528. https://doi.org/10.3390/diagnostics13091528
Ramji HF, Hafiz M, Altaq HH, Hussain ST, Chaudry F. Acute Respiratory Distress Syndrome; A Review of Recent Updates and a Glance into the Future. Diagnostics. 2023; 13(9):1528. https://doi.org/10.3390/diagnostics13091528
Chicago/Turabian StyleRamji, Husayn F., Maida Hafiz, Hiba Hammad Altaq, Syed Talal Hussain, and Fawad Chaudry. 2023. "Acute Respiratory Distress Syndrome; A Review of Recent Updates and a Glance into the Future" Diagnostics 13, no. 9: 1528. https://doi.org/10.3390/diagnostics13091528