In the 1980s, a paradigm shift in the treatment of acute respiratory distress syndrome (ARDS) occurred: researchers found that decreasing tidal volumes provided by mechanical ventilation still allowed for adequate ventilation while, perhaps, avoiding excess lung injury. Based on this principle, high-frequency oscillatory ventilation (HFOV), which provides very small tidal volumes (1 to 2 ml… Read More…
In the latest article in our Clinical Therapeutics review series, a 41-year-old woman presents with severe pneumonia, and the acute respiratory distress syndrome (ARDS) develops. Despite mechanical ventilation, her oxygenation deteriorates. The use of extracorporeal membrane oxygenation (ECMO) is recommended. ARDS is characterized by the acute onset of hypoxemia and bilateral pulmonary infiltrates consistent with… Read More…
In March of 2010, during an overnight shift in the medical intensive care unit, I was paged to rush to the bedside of a patient being wheeled in with rapidly worsening hypoxemic respiratory failure. The patient was quickly intubated, yet still difficult to oxygenate. The X-ray showed bilateral, patchy infiltrates. Once it was determined these… Read More…
