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Acute respiratory distress syndrome following cardiovascular surgery: current concepts and novel therapeutic approaches.

Identifieur interne : 000162 ( Main/Exploration ); précédent : 000161; suivant : 000163

Acute respiratory distress syndrome following cardiovascular surgery: current concepts and novel therapeutic approaches.

Auteurs : Sandra Hoegl [États-Unis] ; Bernhard Zwissler ; Holger K. Eltzschig ; Christine Vohwinkel

Source :

RBID : pubmed:26598954

Descripteurs français

English descriptors

Abstract

PURPOSE OF REVIEW

This review gives an update on current treatment options and novel concepts on the prevention and treatment of the acute respiratory distress syndrome (ARDS) in cardiovascular surgery patients.

RECENT FINDINGS

The only proven beneficial therapeutic options in ARDS are those that help to prevent further ventilator-induced lung injury, such as prone position, use of lung-protective ventilation strategies, and extracorporeal membrane oxygenation. In the future also new approaches like mesenchymal cell therapy, activation of hypoxia-elicited transcription factors or targeting of purinergic signaling may be successful outside the experimental setting. Owing to the so far limited treatment options, it is of great importance to determine patients at risk for developing ARDS already perioperatively. In this context, serum biomarkers and lung injury prediction scores could be useful.

SUMMARY

Preventing ARDS as a severe complication in the cardiovascular surgery setting may help to reduce morbidity and mortality. As cardiovascular surgery patients are of greater risk to develop ARDS, preventive interventions should be implemented early on. Especially, use of low tidal volumes, avoiding of fluid overload and restrictive blood transfusion regimes may help to prevent ARDS.


DOI: 10.1097/ACO.0000000000000283
PubMed: 26598954
PubMed Central: PMC4689613


Affiliations:


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Le document en format XML

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<term>Respiratory Distress Syndrome, Adult (etiology)</term>
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<p>The only proven beneficial therapeutic options in ARDS are those that help to prevent further ventilator-induced lung injury, such as prone position, use of lung-protective ventilation strategies, and extracorporeal membrane oxygenation. In the future also new approaches like mesenchymal cell therapy, activation of hypoxia-elicited transcription factors or targeting of purinergic signaling may be successful outside the experimental setting. Owing to the so far limited treatment options, it is of great importance to determine patients at risk for developing ARDS already perioperatively. In this context, serum biomarkers and lung injury prediction scores could be useful.</p>
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<p>Preventing ARDS as a severe complication in the cardiovascular surgery setting may help to reduce morbidity and mortality. As cardiovascular surgery patients are of greater risk to develop ARDS, preventive interventions should be implemented early on. Especially, use of low tidal volumes, avoiding of fluid overload and restrictive blood transfusion regimes may help to prevent ARDS.</p>
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