PMID- 36439591
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221129
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 10
DP  - 2022 Oct
TI  - A Comprehensive Review of the Management of Acute Respiratory Distress Syndrome.
PG  - e30669
LID - 10.7759/cureus.30669 [doi]
LID - e30669
AB  - Acute respiratory distress syndrome (ARDS) is an inflammatory process in the 
      lungs that induces non-hydrostatic protein-rich pulmonary edema. ARDS occurs in 
      roughly half of coronavirus disease 2019 (COVID-19) pneumonia patients, with most 
      of them requiring intensive care. Oxygen saturation, partial pressure of the 
      oxygen, and the fraction of the inspired oxygen are health indicators that may 
      indicate a severe illness necessitating further investigation. As treatments have 
      evolved, a typical pattern of ARDS has likewise evolved. In cases where 
      mechanical ventilation is required, the use of low tidal volumes (<6 ml/kg ideal 
      body weight) and airway pressures (plateau pressure <30 cmH(2)O) was recommended. 
      For patients with moderate/severe ARDS (partial pressure to fractional inspired 
      oxygen ratio <20), prone positioning was recommended for at least 16 hours per 
      day. By contrast, high-frequency oscillation was not recommended. The use of 
      inhaled vasodilators was recommended in patients with persistent hypoxemia 
      despite invasive ventilation and prone position until extracorporeal membrane 
      oxygenation (ECMO). The use of a conservative fluid management strategy was 
      suggested for all patients. Mechanical ventilation with high positive 
      end-expiratory pressure (PEEP) was suggested for patients with ARDS with a ratio 
      of arterial oxygen partial pressure to fractional inspired oxygen (PF) ratios. 
      ECMO was suggested as an adjunct to protective mechanical ventilation for 
      patients with severe ARDS. In the absence of adequate evidence, research 
      recommendations were made for corticosteroids and extracorporeal carbon dioxide 
      removal. While decades of research have been conducted, treatment options for 
      underlying pathologies remain limited, and mechanical ventilation, which removes 
      carbon dioxide from the body, remains essential to achieving better clinical 
      outcomes. This review aims to identify the best ARDS treatments that are 
      currently available.
CI  - Copyright (c) 2022, Ajibowo et al.
FAU - Ajibowo, Abimbola O
AU  - Ajibowo AO
AD  - Internal Medicine, Lugansk Medical University, Lugansk, UKR.
FAU - Kolawole, Olasunkanmi A
AU  - Kolawole OA
AD  - Internal Medicine, University of Texas School of Public Health, Houston, USA.
FAU - Sadia, Haleema
AU  - Sadia H
AD  - Internal Medicine, Khyber Teaching Hospital, Peshawar, PAK.
FAU - Amedu, Oyovwike S
AU  - Amedu OS
AD  - Medicine, Federal Medical Centre Abeokuta, Abeokuta, NGA.
FAU - Chaudhry, Hassan A
AU  - Chaudhry HA
AD  - Interdisciplinary Medicine, Independent Research Scholar, Philadelphia, USA.
FAU - Hussaini, Helai
AU  - Hussaini H
AD  - ENT, Jamhoryat, Toronto, CAN.
FAU - Hambolu, Eloho
AU  - Hambolu E
AD  - Family Medicine, Sacred Heart Hospital, Lantoro, Abeokuta, NGA.
FAU - Khan, Tuba
AU  - Khan T
AD  - Medicine and Surgery, Ziauddin University, Karachi, PAK.
FAU - Kauser, Humaira
AU  - Kauser H
AD  - General Medicine, Dr. NTR University of Health Sciences, Vijayawada, IND.
FAU - Khan, Aadil
AU  - Khan A
AD  - Internal Medicine, Lala Lajpat Rai Hospital, Kanpur, IND.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20221025
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9686454
OTO - NOTNLM
OT  - ards (acute respiratory distress syndrome)
OT  - covid induced ards
OT  - mechanical ventilation
OT  - rescue therapy ards
OT  - surfactant therapy
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/11/29 06:00
MHDA- 2022/11/29 06:01
PMCR- 2022/10/25
CRDT- 2022/11/28 04:40
PHST- 2022/10/25 00:00 [accepted]
PHST- 2022/11/28 04:40 [entrez]
PHST- 2022/11/29 06:00 [pubmed]
PHST- 2022/11/29 06:01 [medline]
PHST- 2022/10/25 00:00 [pmc-release]
AID - 10.7759/cureus.30669 [doi]
PST - epublish
SO  - Cureus. 2022 Oct 25;14(10):e30669. doi: 10.7759/cureus.30669. eCollection 2022 
      Oct.