ALI und ARDS – was ist therapeutisch gesichert?

Abstract

Every year, more information accumulates about the pathomechanisms and the possibility of treating patients with acute lung injury or acute respiratory distress syndrome. Protective ventilation using a tidal volume of 6 ml/kg ideal body weight (pbw), a pressure limit below 30mbar and a FiO2 as low as possible is currently the only therapeutic strategy whereby the mortality rate of patients with ALI/ARDS can be effectively reduced. Therefore, the consistent use of lung-protective ventilation has priority over all other therapeutic options.

Furthermore are there therapeutic strategies to improve outcome beyond protective ventilation? In this article, we discuss substantial options of mechanical ventilation together with some adjunctive interventions, such as recruitment maneuvers, prone positioning and inhalation of nitric oxide.

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