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2014 ; 146
(4
): 1102-1113
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Preventing ARDS: progress, promise, and pitfalls
#MMPMID25288000
Beitler JR
; Schoenfeld DA
; Thompson BT
Chest
2014[Oct]; 146
(4
): 1102-1113
PMID25288000
show ga
Advances in critical care practice have led to a substantial decline in the
incidence of ARDS over the past several years. Low tidal volume ventilation,
timely resuscitation and antimicrobial administration, restrictive transfusion
practices, and primary prevention of aspiration and nosocomial pneumonia have
likely contributed to this reduction. Despite decades of research, there is no
proven pharmacologic treatment of ARDS, and mortality from ARDS remains high.
Consequently, recent initiatives have broadened the scope of lung injury research
to include targeted prevention of ARDS. Prediction scores have been developed to
identify patients at risk for ARDS, and clinical trials testing aspirin and
inhaled budesonide/formoterol for ARDS prevention are ongoing. Future trials
aimed at preventing ARDS face several key challenges. ARDS has not been validated
as an end point for pivotal clinical trials, and caution is needed when testing
toxic therapies that may prevent ARDS yet potentially increase mortality.