Erschienen in:
11.08.2016 | Editorial
Will all ARDS patients be receiving mechanical ventilation in 2035? No
verfasst von:
Matthieu Schmidt, Peter M. Spieth, Alberto Zanella
Erschienen in:
Intensive Care Medicine
|
Ausgabe 4/2017
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Excerpt
Despite serious side effects, mechanical ventilation (MV) is universally recognized as a lifesaving intervention to improve gas exchange or replace fatigued respiratory muscles of patients in respiratory failure. However, MV itself can cause ventilator-induced lung injury (VILI), as first described in the 1980s. Since then, our understanding of acute respiratory distress syndrome (ARDS) pathophysiology has dramatically improved, leading to the concept of protective MV. Scientific and clinical efforts have both led to a significant but still incomplete reduction of lung harm. Consequently, despite initial reduction, ARDS patients’ deaths remain unacceptably high. Mortality rates for a recent multicenter cohort of mild, moderate, and severe ARDS patients were 35, 40, and 46 %, respectively [
1]. Although lowering the tidal volume also lowered mortality—despite initially worse oxygenation—we advance that the current protective MV strategies cannot sufficiently minimize VILI and foster lung healing [
2]. …
