Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000126.xml
Intensivmedizin up2date 2020; 16(02): 139-147
DOI: 10.1055/a-1056-8024
DOI: 10.1055/a-1056-8024
Schritt für Schritt
Akutes Lungenversagen (ARDS) – Schritt für Schritt
Das akute Lungenversagen (acute respiratory distress syndrome, ARDS) ist mit einer Letalität von etwa 40% eine massiv lebensbedrohliche Erkrankung. Dennoch wird das Krankheitsbild häufig zu spät oder gar nicht erkannt. Zugleich kann durch eine adäquate Therapie das Outcome der Patienten deutlich verbessert werden. Der Beitrag stellt die wichtigsten Prinzipien für eine frühe Diagnose und eine leitliniengerechte Therapie des ARDS dar.
Publication History
Article published online:
28 May 2020
Georg Thieme Verlag KG
Stuttgart · New York
-
Literatur
- 1 Imai Y, Kuba K, Neely GG. et al. Identification of oxidative stress and Toll-like receptor 4 signaling as a key pathway of acute lung injury. Cell 2008; 133: 235-249 doi:10.1016/j.cell.2008.02.043
- 2 Bhattacharya J, Matthay MA. Regulation and repair of the alveolar-capillary barrier in acute lung injury. Annu Rev Physiol 2013; 75: 593-615 doi:10.1146/annurev-physiol-030212-183756
- 3 Zemans RL, Matthay MA. Bench-to-bedside review: the role of the alveolar epithelium in the resolution of pulmonary edema in acute lung injury. Crit Care 2004; 8: 469-477 doi:10.1186/cc2906
- 4 Huppert LA, Matthay MA, Ware LB. Pathogenesis of acute respiratory distress syndrome. Semin Respir Crit Care Med 2019; 40: 031-039 doi:10.1055/s-0039-1683996
- 5 Coudroy R, Chen L, Pham T. et al. Acute respiratory distress syndrome: respiratory monitoring and pulmonary physiology. Semin Respir Crit Care Med 2019; 40: 66-80 doi:10.1055/s-0039-1685159
- 6 Imai Y, Parodo J, Kajikawa O. et al. Injurious mechanical ventilation and end-organ epithelial cell apoptosis and organ dysfunction in an experimental model of acute respiratory distress syndrome. JAMA 2003; 289: 2104-2112 doi:10.1001/jama.289.16.2104
- 7 Bates JHT, Smith BJ. Ventilator-induced lung injury and lung mechanics. Ann Transl Med 2018; 6: 378-378 doi:10.21037/atm.2018.06.29
- 8 Tremblay LN, Slutsky AS. Ventilator-induced injury: from barotrauma to biotrauma. Proc Assoc Am Physicians 1998; 110: 482-488
- 9 ARDS Definition Task Force. Ranieri VM, Rubenfeld GD. et al. Acute Respiratory Distress Syndrome: The Berlin Definition. JAMA 2012; 307: 2526-2533 doi:10.1001/jama.2012.5669
- 10 Bellani G, Laffey JG, Pham T. et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 2016; 315: 788-800 doi:10.1001/jama.2016.0291
- 11 Phua J, Badia JR, Adhikari NK. et al. Has mortality from acute respiratory distress syndrome decreased over time?: A systematic review. Am J Respir Crit Care Med 2009; 179: 220-227 doi:10.1164/rccm.200805-722OC
- 12 Villar J, Blanco J, Anon JM. et al. The ALIEN study: incidence and outcome of acute respiratory distress syndrome in the era of lung protective ventilation. Intensive Care Med 2011; 37: 1932-1941 doi:10.1007/s00134-011-2380-4
- 13 Ferguson ND, Frutos-Vivar F, Esteban A. et al. Acute respiratory distress syndrome: underrecognition by clinicians and diagnostic accuracy of three clinical definitions. Crit Care Med 2005; 33: 2228-2234 doi:10.1097/01.ccm.0000181529.08630.49
- 14 Frohlich S, Murphy N, Doolan A. et al. Acute respiratory distress syndrome: underrecognition by clinicians. J Crit Care 2013; 28: 663-668 doi:10.1016/j.jcrc.2013.05.012
- 15 Adamzik M, Bauer A, Bein T. et al. S3-Leitlinie Invasive Beatmung und Einsatz extrakorporaler Verfahren bei akuter respiratorischer Insuffizienz. AWMF Leitlinien-Register Nr. 001/021. Im Internet: https://www.awmf.org/uploads/tx_szleitlinien/001-021l_S3_Invasive_Beatmung_2017-12.pdf. Stand: 20.11.2017
- 16 Antonelli M, Conti G, Moro ML. et al. Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: a multi-center study. Intensive Care Med 2001; 27: 1718-1728 doi:10.1007/s00134-001-1114-4
- 17 Westhoff M, Schönhofer B, Neumann P. et al. S3-Leitlinie Nicht-invasive Beatmung als Therapie der akuten respiratorischen Insuffizienz. AWMF Leitlinien-Register Nr. 020/004. Im Internet: https://www.awmf.org/uploads/tx_szleitlinien/020-004l_Nichtinvasive_Beatmung_ARI_2015-09-verlaengert.pdf. Stand: 10.07.2015
- 18 Laffey JG, Kavanagh BP. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury. N Engl J Med 2000; 343: 812 doi:10.1056/NEJM200009143431113 author reply 813–814
- 19 Tonelli AR, Zein J, Adams J. et al. Effects of interventions on survival in acute respiratory distress syndrome: an umbrella review of 159 published randomized trials and 29 meta-analyses. Intensive Care Med 2014; 40: 769-787 doi:10.1007/s00134-014-3272-1
- 20 Raymondos K, Dirks T, Quintel M. et al. Outcome of acute respiratory distress syndrome in university and non-university hospitals in Germany. Crit Care 2017; 21: 122 doi:10.1186/s13054-017-1687-0
- 21 Amato MB, Meade MO, Slutsky AS. et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 2015; 372: 747-755 doi:10.1056/NEJMsa1410639
- 22 Guerin C, Papazian L, Reignier J. et al. Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials. Crit Care 2016; 20: 384 doi:10.1186/s13054-016-1556-2
- 23 Toufen Junior C, De Santis Santiago RR, Hirota AS. et al. Driving pressure and long-term outcomes in moderate/severe acute respiratory distress syndrome. Ann Intensive Care 2018; 8: 119 doi:10.1186/s13613-018-0469-4
- 24 Lachmann B. Open up the lung and keep the lung open. Intensive Care Med 1992; 18: 319-321 doi:10.1007/bf01694358
- 25 Writing Group for the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART) Investigators. Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs. low PEEP on mortality in patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA 2017; 318: 1335-1345 doi:10.1001/jama.2017.14171
- 26 Brower RG, Lanken PN, MacIntyre N. et al. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. N Engl J Med 2004; 351: 327-336 doi:10.1056/NEJMoa032193
- 27 Walkey AJ, Del Sorbo L, Hodgson CL. et al. Higher PEEP versus lower PEEP strategies for patients with acute respiratory distress syndrome. A systematic review and meta-analysis. Ann Am Thorac Soc 2017; 14 (Suppl. 04) S297-S303 doi:10.1513/AnnalsATS.201704-338OT
- 28 Gainnier M, Roch A, Forel JM. et al. Effect of neuromuscular blocking agents on gas exchange in patients presenting with acute respiratory distress syndrome. Crit Care Med 2004; 32: 113-119 doi:10.1097/01.CCM.0000104114.72614.BC
- 29 Papazian L, Forel JM, Gacouin A. et al. Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 2010; 363: 1107-1116 doi:10.1056/NEJMoa1005372
- 30 Putensen C, Zech S, Wrigge H. et al. Long-term effects of spontaneous breathing during ventilatory support in patients with acute lung injury. Am J Respir Crit Care Med 2001; 164: 43-49 doi:10.1164/ajrccm.164.1.2001078
- 31 Sassoon CS, Zhu E, Caiozzo VJ. Assist-control mechanical ventilation attenuates ventilator-induced diaphragmatic dysfunction. Am J Respir Crit Care Med 2004; 170: 626-632 doi:10.1164/rccm.200401-042OC
- 32 Wrigge H, Zinserling J, Neumann P. et al. Spontaneous breathing improves lung aeration in oleic acid-induced lung injury. Anesthesiology 2003; 99: 376-384 doi:10.1097/00000542-200308000-00019
- 33 Yoshida T, Fujino Y, Amato MB. et al. Fifty years of research in ARDS. Spontaneous breathing during mechanical ventilation. Risks, mechanisms, and management. Am J Respir Crit Care Med 2017; 195: 985-992 doi:10.1164/rccm.201604-0748CP
- 34 Guerin C, Reignier J, Richard JC. et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 2013; 368: 2159-2168 doi:10.1056/NEJMoa1214103
- 35 Sud S, Friedrich JO, Taccone P. et al. Prone ventilation reduces mortality in patients with acute respiratory failure and severe hypoxemia: systematic review and meta-analysis. Intensive Care Med 2010; 36: 585-599 doi:10.1007/s00134-009-1748-1
- 36 Charron C, Bouferrache K, Caille V. et al. Routine prone positioning in patients with severe ARDS: feasibility and impact on prognosis. Intensive Care Med 2011; 37: 785-790 doi:10.1007/s00134-011-2180-x
- 37 Bein T, Bischoff M, Brückner U. et al. S2e-Leitlinie Lagerungstherapie und Frühmobilisation zur Prophylaxe oder Therapie von pulmonalen Funktionsstörungen AWMF Leitlinien-Register Nr. 001/015. Im Internet: https://www.awmf.org/uploads/tx_szleitlinien/001-015l_S2e_Lagerungstherapie_Frühmobilisation_pulmonale_Funktionsstörungen_2015-05.pdf. Stand: 30.04.2015
- 38 Kalisch BJ, Dabney BW, Lee S. Safety of mobilizing hospitalized adults: review of the literature. J Nurs Care Qual 2013; 28: 162-168 doi:10.1097/NCQ.0b013e31827c10d5
- 39 Lewis SR, Pritchard MW, Thomas CM. et al. Pharmacological agents for adults with acute respiratory distress syndrome. Cochrane Database Syst Rev 2019; (07) CD004477 DOI: 10.1002/14651858.CD004477.pub3.
- 40 Gao Smith F, Perkins GD, Gates S. et al. Effect of intravenous beta-2 agonist treatment on clinical outcomes in acute respiratory distress syndrome (BALTI-2): a multicentre, randomised controlled trial. Lancet 2012; 379: 229-235 doi:10.1016/s0140-6736(11)61623-1
- 41 Gebistorf F, Karam O, Wetterslev J. et al. Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) in children and adults. Cochrane Database Syst Rev 2016; (06) CD002787 DOI: 10.1002/14651858.CD002787.pub3.
- 42 Silversides JA, Major E, Ferguson AJ. et al. Conservative fluid management or deresuscitation for patients with sepsis or acute respiratory distress syndrome following the resuscitation phase of critical illness: a systematic review and meta-analysis. Intensive Care Med 2017; 43: 155-170 doi:10.1007/s00134-016-4573-3
- 43 Bein T, Weber-Carstens S, Goldmann A. et al. Lower tidal volume strategy (approximately 3 ml/kg) combined with extracorporeal CO2 removal versus ‘conventional’ protective ventilation (6 ml/kg) in severe ARDS: the prospective randomized Xtravent-study. Intensive Care Med 2013; 39: 847-856 doi:10.1007/s00134-012-2787-6
- 44 Fitzgerald M, Millar J, Blackwood B. et al. Extracorporeal carbon dioxide removal for patients with acute respiratory failure secondary to the acute respiratory distress syndrome: a systematic review. Crit Care 2014; 18: 222 doi:10.1186/cc13875
- 45 Barbaro RP, Odetola FO, Kidwell KM. et al. Association of hospital-level volume of extracorporeal membrane oxygenation cases and mortality. Analysis of the extracorporeal life support organization registry. Am J Respir Crit Care Med 2015; 191: 894-901 doi:10.1164/rccm.201409-1634OC