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Acut Lung Injuri ARDS 2020
Acut Lung Injuri ARDS 2020
Key points Acute lung injury (ALI) is a common condition for hypoxaemia. It is possible, for example, to
that is characterized by acute severe hypoxia improve the PaO2/FIO2 ratio of patients meeting
Table 1 Diagnostic criteria for ALI Table 3 Chest radiograph abnormalities. LVF, left ventricular failure
Continuing Education in Anaesthesia, Critical Care & Pain j Volume 9 Number 5 2009 153
ALI and ARDS
154 Continuing Education in Anaesthesia, Critical Care & Pain j Volume 9 Number 5 2009
ALI and ARDS
significant reduction in this process after the administration of AVECCO2R have interventional procedure guidance available
methylprednisolone,8 the ARDSnet group performed a large multi- from the National Institute for Health and Clinical Excellence.
centre randomized controlled trial using the same trial protocol.9
This new larger study failed to show a difference in hospital mor- Physiotherapy and positioning
tality. On the basis of these studies, the routine use of methylpred- The role of physiotherapy in ARDS is uncertain and little evidence
nisolone is not recommended in patients with ALI. exists concerning its use. Aims of physiotherapy in ARDS are
similar to those in most ICU patients—to promote the removal of
Prone positioning retained secretions and to encourage active and passive movements
in patients who are often bed bound for a long period of time.
Prone positioning has been demonstrated to enhance oxygenation Methods used to achieve these aims include:
Continuing Education in Anaesthesia, Critical Care & Pain j Volume 9 Number 5 2009 155
ALI and ARDS
individual cases, but there is insufficient evidence to recommend 7. The Acute Respiratory Distress Syndrome Network. Comparison of
their widespread use for all patients. two fluid-management strategies in acute lung injury. N Engl J Med 2006;
354: 2564– 75
8. Meduri GU, Headley AS, Golden E et al. Effect of prolonged methylpred-
References nisolone therapy in unresolving acute respiratory distress syndrome: a
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