Moderate to Severe Acute Respiratory Distress Syndrome Management Strategies: A Narrative Review

Journal of Pharmacy Practice
Mitchell S BuckleyJeffrey P Gonzales

Abstract

Acute respiratory distress syndrome (ARDS) remains a common complication associated with significant negative outcomes in critically ill patients. Lung-protective mechanical ventilation strategies remain the cornerstone in the management of ARDS. Several therapeutic options are currently available including fluid management, neuromuscular blocking agents, prone positioning, extracorporeal membrane oxygenation, corticosteroids, and inhaled pulmonary vasodilating agents (prostacyclins and nitric oxide). Unfortunately, an evidence-based, standard-of-care approach in managing ARDS beyond lung-protective ventilation remains elusive, contributing to significant variability in clinical practice. Although the optimal therapeutic strategy for managing moderate to severe ARDS remains extremely controversial, therapies supported with more robust clinical evidence should be considered first. The purpose of this narrative review is to discuss the published clinical evidence for both pharmacologic and nonpharmacologic management strategies in adult patients with moderate to severe ARDS as well as to discuss practical considerations for implementation.

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Citations

Aug 28, 2020·Journal of Aerosol Medicine and Pulmonary Drug Delivery·Ola ElnadouryAnthony S Lubinsky
Jul 12, 2019·Journal of Pharmacy Practice·Sandra L Kane-Gill, Amy L Dzierba

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Methods Mentioned

BETA
sedation

Software Mentioned

FACTT Lite
ACURASYS
PROSEVA
EOLIA
FACTT

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