In the new century, beginning with the National Institute of Health NIH low tidal volume ventilation, a series of therapeutical approaches have been proposed and tested in ARDS, some successful, as prone position and artificial lung support in severe ARDS, some unsuccessful, as high frequency ventilation, and some still questionable and debated, as the use of higher PEEP compared to lower PEEP. At the same time, the mechanisms of ventilation induced lung injury, the primary risk of mechanical ventilation in ARDS, have been furtherly investigated both in its physical and biological components. Recently this bulk of knowledge has been embedded in the Berlin ARDS definition, which pragmatically classifies the degree of severity of the syndrome and, more important, suggests possible treatments scaled to the severity. It is not clear, however, within a certain degree of severity which criteria should guide the possible alternative treatment. As an example, in severe ARDS, prone position, extracorporeal oxygenation should be applied separately or in combination? And, more important, should these techniques be available in every hospital or concentrated in referral centers?

Meet the expert session: ARDS management at bedside / L. Gattinoni. ((Intervento presentato al convegno Internation winter symposium in intensive care medicine tenutosi a Zermatt nel 2015.

Meet the expert session: ARDS management at bedside

L. Gattinoni
Primo
2015

Abstract

In the new century, beginning with the National Institute of Health NIH low tidal volume ventilation, a series of therapeutical approaches have been proposed and tested in ARDS, some successful, as prone position and artificial lung support in severe ARDS, some unsuccessful, as high frequency ventilation, and some still questionable and debated, as the use of higher PEEP compared to lower PEEP. At the same time, the mechanisms of ventilation induced lung injury, the primary risk of mechanical ventilation in ARDS, have been furtherly investigated both in its physical and biological components. Recently this bulk of knowledge has been embedded in the Berlin ARDS definition, which pragmatically classifies the degree of severity of the syndrome and, more important, suggests possible treatments scaled to the severity. It is not clear, however, within a certain degree of severity which criteria should guide the possible alternative treatment. As an example, in severe ARDS, prone position, extracorporeal oxygenation should be applied separately or in combination? And, more important, should these techniques be available in every hospital or concentrated in referral centers?
5-feb-2015
Settore MED/41 - Anestesiologia
Meet the expert session: ARDS management at bedside / L. Gattinoni. ((Intervento presentato al convegno Internation winter symposium in intensive care medicine tenutosi a Zermatt nel 2015.
Conference Object
File in questo prodotto:
Non ci sono file associati a questo prodotto.
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/267640
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact