[Current strategies for the diagnosis and treatment of acute respiratory distress syndrome]

Abstract

Acute respiratory distress syndrome is a frequently encountered condition in the intensive care units, with high mortality rates despite cumulating knowledge on its pathogenesis. It is important that cardiac pulmonary edema should be ruled out for diagnosis. Different mechanical ventilation strategies, as well as agents for the control of inflammation are being tested. Currently, low tidal volume ventilation with high PEEP and plateau pressures below 30 cmH(2)O is the only intervention that has been shown to improve survival significantly. Low dose steroids, nitric oxide inhalation, surfactant, antioxidants, Beta(2) adrenergic agents, HMG-CoA reductase inhibitors are promising agents. Fluid restriction and immunonutrition should be considered when these patients are being cared for.