Management of ARDS: From ventilation strategies to intelligent technical support – Connecting the dots

Trends in Anaesthesia and Critical Care, vol. 34, pp. 50–58

Abstract

Since its first scientific description in modern medicine as “acute respiratory distress in adults” in 1967, the acute respiratory distress syndrome (ARDS) has been extensively studied, but physicians worldwide still face high morbidity and mortality. Due to the unspecific criteria for definition of ARDS and its predecessor-definitions, accompanied by broad changes in medical care over the last decades, it is still challenging to deduct reliable conclusions based on epidemiologic data. Nevertheless, science has made relevant progress in understanding pathophysiology, risk factors and in developing therapeutic strategies to improve patient-outcome. In this review, we will discuss the historical evolution of ARDS, main components of pathophysiology and associated treatment-strategies according to the German interdisciplinary guideline for respiratory failure. In view of current diagnostic approaches and evidence-based therapeutic measures, we will summarize and discuss recent epidemiologic data in order to identify weaknesses in disease-management and depict possible future solutions to improve healthcare in ARDS.

Authors 5

1. Sebastian Johannes Fritsch Aachen Department of Intensive Care Medicine and Intermediate Care

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Intensive Care Medicine and Intermediate Care, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

   SMITH Consortium of the German Medical Informatics Initiative, Aachen, Germany

2. Arne Peine Aachen Department of Intensive Care Medicine and Intermediate Care

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Intensive Care Medicine and Intermediate Care, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

3. Oliver Maaßen Aachen Department of Intensive Care Medicine and Intermediate Care

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Intensive Care Medicine and Intermediate Care, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

   SMITH Consortium of the German Medical Informatics Initiative, Aachen, Germany

4. Gernot Marx Aachen Department of Intensive Care Medicine and Intermediate Care

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Intensive Care Medicine and Intermediate Care, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

   SMITH Consortium of the German Medical Informatics Initiative, Aachen, Germany

5. Johannes Bickenbach Aachen Department of Intensive Care Medicine and Intermediate Care

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Intensive Care Medicine and Intermediate Care, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

   SMITH Consortium of the German Medical Informatics Initiative, Aachen, Germany