SCCM Resource Library-ARDS: Will Precision Approaches Move the Needle?

Pdf Summary

This document discusses the historical and evolving understanding of Acute Respiratory Distress Syndrome (ARDS), particularly highlighting how treatment approaches have changed over time and in the context of the COVID-19 pandemic. The historical section notes the early recognition of ARDS in the 1960s and 70s, with the use of positive end-expiratory pressure (PEEP) to improve ventilation initially being key, though larger tidal volumes were later found to potentially cause lung injury.<br /><br />Dr. Daniel S. Talmor, a key figure mentioned in the document, emphasizes how approaches to ARDS evolved through the decades. By the mid-1980s, large tidal volumes were reevaluated after research illustrated that smaller tidal volumes could improve outcomes. This led to a shift in medical practice, prioritizing the prevention of lung injury over attaining normal oxygenation levels.<br /><br />The document also covers contemporary challenges and opportunities in ARDS treatment, focusing on patient-specific strategies. Dr. Talmor advocates for personalized medicine, moving away from uniform treatment protocols to tailored care that considers individual patient differences. This includes utilizing tools like Electrical Impedance Tomography (EIT) to optimize ventilation settings.<br /><br />Speakers, including Eddy Fan, MD, Alice Gallo De Moraes, MD, and Richard D. Branson, MSc, highlight the parallels between ARDS from COVID-19 and other causes, suggesting consistent treatment methods while recognizing unique challenges posed by COVID-19.<br /><br />Finally, future directions in ARDS treatment are considered, with the potential for closed-loop ventilation systems and other technological advances that automate and refine patient care. Dr. Talmor underscores the importance of critical care physicians maintaining oversight and adaptability amid these advancements, likening their role to pilots managing complex systems in aviation.

Asset Subtitle

Pulmonary, Crisis Management, 2021, 00:05:16

Asset Caption

This article was first published in the Summer 2021 issue of Critical Connections.

The Peter Safar Memorial Lecture, ARDS: Will Precision Approaches Move the Needle? sought to identify COVID-19’s link to ARDS, reveal the failings in past approaches to ARDS treatment, and describe current
and future opportunities for individualizing therapy for patients with ARDS. “COVID-19 manifests itself in ARDS,” Dr. Talmor said at the beginning of his presentation. “This is a disease that’s been around for
more than 50 years, one that we’ve battled with often, and one in which we’re making great progress.”

Critical Connections, the critical care industry's only newsmagazine, provides information on cutting-edge topics in critical care useful to the entire multiprofessional team.Daniel S. Talmor, MD, MPH

Meta Tag

Content Type Article

Knowledge Area Pulmonary

Knowledge Area Crisis Management

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Membership Level Professional

Membership Level Associate

Tag Acute Respiratory Distress Syndrome ARDS

Tag COVID-19

Year 2021

Keywords

Acute Respiratory Distress Syndrome

ARDS

COVID-19

positive end-expiratory pressure

tidal volumes

personalized medicine

Electrical Impedance Tomography

ventilation

closed-loop systems

Dr. Daniel S. Talmor

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