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01-04-2017 | Editorial

Will all ARDS patients be receiving mechanical ventilation in 2035? No

Authors: Matthieu Schmidt, Peter M. Spieth, Alberto Zanella

Published in: Intensive Care Medicine | Issue 4/2017

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]. …

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Title: Will all ARDS patients be receiving mechanical ventilation in 2035? No
Authors: Matthieu Schmidt
Peter M. Spieth
Alberto Zanella
Publication date: 01-04-2017
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 4/2017
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-016-4487-0

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