PaO₂:FiO₂ Ratio
Acute respiratory distress syndrome (ARDS) is classically described as noncardiogenic pulmonary edema, thought to be secondary to increased pulmonary capillary permeability. This process may occur for a number of reasons, both pulmonary and systemic in origin. Common causes of ARDS include pulmonary or systemic infection, trauma, burns, pancreatitis, near-drowning, transfusion, medication overdose, and toxic inhalations.
Treatment of ARDS is evolving, with several recent large-scale studies that have altered standard practice:
- Low tidal volume ventilation (6mL/kg) improves absolute mortality 9% (ARDSNet, 2000)
- Restrictive fluid management strategies (initiated after hemodynamic stabilization) increases ventilation-free and ICU-free days, but has no effect on 60-day mortality (ARDSNet, 2006)
- High versus low levels of positive end-expiratory pressure (PEEP) has no effect on clinically relevant outcomes (Brower et al, 2004)
- No benefit, but increased complication rates when pulmonary arterial catheters are used to guide treatment (ARDSNet, 2006)
- Steroid therapy increases morbidity and possibly increases mortality, especially if initiated late (> 14 days) in ARDS course (Steinberg et al, 2006)
- [1]Roy G Brower et al.: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.New England Journal of Medicine 2000 May 4, 342 (18): 1301-8
- [2]Herbert P Wiedemann et al.: Comparison of two fluid-management strategies in acute lung injury.New England Journal of Medicine 2006 June 15, 354 (24): 2564-75
- [3]Brower RG, et al.: Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome.New England Journal of Medicine 2004 July 22, 351 (4): 327-36
- [4]Arthur P Wheeler et al.: Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury.New England Journal of Medicine 2006 May 25, 354 (21): 2213-24
- [5]Steinberg KP et al.: Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome.New England Journal of Medicine 2006 April 20, 354 (16): 1671-84
Results
Real-time automated computation
2. Bilater patchy airspace disease
3. PaO₂:FiO₂ ratio ≤ 200
4. Absence of left heart failure
Acute respiratory distress syndrome (ARDS) is classically described as noncardiogenic pulmonary edema, thought to be secondary to increased pulmonary capillary permeability. This process may occur for a number of reasons, both pulmonary and systemic in origin. Common causes of ARDS include pulmonary or systemic infection, trauma, burns, pancreatitis, near-drowning, transfusion, medication overdose, and toxic inhalations.
Treatment of ARDS is evolving, with several recent large-scale studies that have altered standard practice:
- Low tidal volume ventilation (6mL/kg) improves absolute mortality 9% (ARDSNet, 2000)
- Restrictive fluid management strategies (initiated after hemodynamic stabilization) increases ventilation-free and ICU-free days, but has no effect on 60-day mortality (ARDSNet, 2006)
- High versus low levels of positive end-expiratory pressure (PEEP) has no effect on clinically relevant outcomes (Brower et al, 2004)
- No benefit, but increased complication rates when pulmonary arterial catheters are used to guide treatment (ARDSNet, 2006)
- Steroid therapy increases morbidity and possibly increases mortality, especially if initiated late (> 14 days) in ARDS course (Steinberg et al, 2006)
- [1]Roy G Brower et al.: Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.New England Journal of Medicine 2000 May 4, 342 (18): 1301-8
- [2]Herbert P Wiedemann et al.: Comparison of two fluid-management strategies in acute lung injury.New England Journal of Medicine 2006 June 15, 354 (24): 2564-75
- [3]Brower RG, et al.: Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome.New England Journal of Medicine 2004 July 22, 351 (4): 327-36
- [4]Arthur P Wheeler et al.: Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury.New England Journal of Medicine 2006 May 25, 354 (21): 2213-24
- [5]Steinberg KP et al.: Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome.New England Journal of Medicine 2006 April 20, 354 (16): 1671-84