The ventilatory management of acute respiratory distress syndrome has evolved over last years. The demonstration of ventilator-induced lung injuries, partially due to alveolar overdistension, has promoted the development of ventilatory strategies which allow adequate arterial blood gases and protect the lung from further injuries. Titration of PEEP to maximize alveolar recruitment and limitation of plateau pressure to 35 cmH20 to prevent alveolar overdistension are now recommended. Many experimental studies support this strategy, but clinical randomized studies are still lacking. Several adjuncts (prone position, nitric oxyde, tracheal gas insufflation) to optimize gas exchange are proposed but are not rigorously supported by clinical studies.
|Translated title of the contribution||New ventilatory strategies in the management of acute respiratory distress syndrome|
|Number of pages||5|
|Journal||Medecine et Hygiene|
|State||Published - Oct 14 1998|