Article

Rescue Therapies for Acute Hypoxemic Respiratory Failure

Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA 94143-0624, USA.
Anesthesia and analgesia (Impact Factor: 3.42). 09/2010; 111(3):693-702. DOI: 10.1213/ANE.0b013e3181e9c356
Source: PubMed

ABSTRACT The recent H1N1 epidemic has resulted in a large number of deaths, primarily from acute hypoxemic respiratory failure. We reviewed the current strategies to rescue patients with severe hypoxemia. Included in these strategies are high-frequency oscillatory ventilation, airway pressure release ventilation, inhaled vasodilators, and the use of extracorporeal life support. All of these strategies are targeted at improving oxygenation, but improved oxygenation alone has yet to be demonstrated to correlate with improved survival. The risks and benefits of these strategies, including cost-effectiveness data, are discussed.

Download full-text

Full-text

Available from: Michael Gropper, Dec 16, 2014
3 Followers
 · 
182 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: This article presents a case study demonstrating various rescue therapies considered in the care of a patient with severe, refractory hypoxemia secondary to acute respiratory distress syndrome. In particular, inhaled epoprostenol (Flolan) is becoming an increasingly common alternative to nitric oxide in the treatment of severe, refractory hypoxemia. Research comparing the 2 inhaled vasodilators suggests that epoprostenol is equally efficacious, easier to administer, less costly, and has fewer adverse effects. This article, using a case study approach, discusses the practical implications of this emerging therapy.
    Dimensions of critical care nursing: DCCN 01/2013; 32(5):229-36. DOI:10.1097/DCC.0b013e3182a076f6
  • [Show abstract] [Hide abstract]
    ABSTRACT: Patients are at risk for several types of lung injury in the perioperative period including atelectasis, pneumonia, pneumothorax, acute lung injury, and acute respiratory distress syndrome. Anaesthetic management can cause, exacerbate, or ameliorate these injuries. This review examines the effects of perioperative mechanical ventilation and its role in ventilator-induced lung injury. Lung protective ventilatory strategies to specific clinical situations such as cardiopulmonary bypass and one-lung ventilation along with newer novel lung protective strategies are discussed.
    BJA British Journal of Anaesthesia 12/2010; 105 Suppl 1:i108-16. DOI:10.1093/bja/aeq299 · 4.35 Impact Factor
  • American Journal of Respiratory and Critical Care Medicine 07/2011; 184(1):1-2. DOI:10.1164/rccm.201104-0622ED · 11.99 Impact Factor