ARDS Acute Respiratory Distress in Adults

Timothy W. Evans, C. Haslett (Autoren)

Buch | Softcover

544 Seiten

1996
Hodder Arnold (Verlag)
978-0-412-56910-4 (ISBN)

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Great progress has been made since the first description of the acute respiratory distress syndrome by the Denver group in 1967 (Lancet). Although we introduced the term 'adult respiratory distress syndrome' in our second and more detailed description of the syndrome (ehest, 1971), this was probably amistake for the simple reason that children also suffer the same syndrome fo11owing acute lung insults. Today, the syndrome of acute respiratory distress in adults (ARDS) is recognized as a worldwide problem, but the prevalence of disease varies in different parts of the world. A huge amount of research has focused on the mechanisms of acute lung injury and yet the exact sequence of events and media tors in inflammatory cascade, which result in acute respiratory failure from ARDS, is not known but many possibilities exist. The definition of ARDS has been gradua11y modified in recent years and investigators around the world are now co11aborating in order to establish more uniform concepts in identification, risk factors and mechanisms of lung injury, which someday will result in improved approaches to management. Already, at least some centers are showing improved outcomes in ARDS, achieving an approximate 60% survival rate. In the past, most large series documented only about a 40% survivability taking a11 causes of ARDS. This apparent progress is likely attributable to more meticulous and disciplined care than any specific pharmacologic attack on the basic mechanism resulting in ARDS.

Part 1 Introduction and overview: introduction and definition; epidemiology; spectrum of disease; diffuse alveolar damage. Part 2 Basic mechanisms: mechanisms of resolution of lung inflammation; complement, endotoxin and acute lung injury; cytokines and lung injury; mechanisms of neutrophil mediated injury; adhesion molecules; proteinases; reactive oxygen species, antioxidant protection and lung injury; epithelial injury and repair; mechanisms of scarring; secondary infections in acute lung injury. Part 3 Physiology: pulmonary physiology of acute lung injury; surfactant system in lung injury; pulmonary vascular control mechanisms; systemic manifestations; tissue oxygenation; critical role of the alveolar epithelial barrier. Part 4 Clinical management: imaging the injured lung; severity scoring; a pressure targeted approach to ventilating; high frequency techniques of oxygenation; extracorporeal membrane oxygenation; intravascular gas exchange; clinical trial issues. Part 5 Thrapeutic interventions: fluid balance and renal function; inhaled nitric oxide therapy; prospects for pharmacotherapy.

Erscheint lt. Verlag	4.9.1998
Zusatzinfo	146 Illustrations, black and white
Verlagsort	London
Sprache	englisch
Maße	189 x 246 mm
Themenwelt	Medizinische Fachgebiete ► Innere Medizin ► Pneumologie
Themenwelt	Medizin / Pharmazie ► Medizinische Fachgebiete ► Intensivmedizin
ISBN-10	0-412-56910-8 / 0412569108
ISBN-13	978-0-412-56910-4 / 9780412569104
Zustand	Neuware