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: 3.47). 09/2010; 111(3):693-702. DOI: 10.1213/ANE.0b013e3181e9c356
Source: PubMed


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


Available from: Michael Gropper, Dec 16, 2014
  • [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(Suppl 1):i108-16. DOI:10.1093/bja/aeq299 · 4.85 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: ECMO (Extracorporeal Membrane Oxygenation) es un sistema de soporte vital extracorpóreo en falla pulmonar catastrófica, insuficiencia cardiaca aguda y reanimación de uso cada vez más común. En Chile se ha implementado en distintos centros, con resultados comparables al registro internacional. Cuando el candidato a ser sometido está demasiado inestable como para ser transportado a un hospital que cuente con ECMO, la canulación antes del traslado permite la estabilización y posterior transporte al centro de ECMO. Los resultados en los pacientes transportados son similares a los casos generados en el mismo lugar. En el siguiente artículo revisaremos las definiciones en soporte extracorpóreo, indicaciones y contraindicaciones, los resultados esperables y las experiencias internacionales y propia de Clínica Las Condes en ECMO y ECMO Mobile.
    05/2011; 22(3):377-387. DOI:10.1016/S0716-8640(11)70438-2

  • American Journal of Respiratory and Critical Care Medicine 07/2011; 184(1):1-2. DOI:10.1164/rccm.201104-0622ED · 13.00 Impact Factor
Show more