Anästhesiol Intensivmed Notfallmed Schmerzther 2008; 43(11/12): 756-757
DOI: 10.1055/s-0028-1104615
Fachwissen
Topthema: Lungenversagen
© Georg Thieme Verlag Stuttgart · New York

Lungenversagen – Eine multimodale ARDS–Therapie braucht evidenzbasierte Studien mit klaren Einschlusskriterien

Maria Deja, Matthias Hommel, Anton Goldmann, Christian Pille, Vera von Dossow, Christian Lojewski, Claudia Spies
Further Information

Publication History

Publication Date:
18 November 2008 (online)

Das ARDS mag selten vorkommen, doch seine Therapie ist von besonderem Gewicht. Sowohl die Verweildauer als auch die hohe Sterblichkeit der Patienten mit schwerem ARDS erfordern einen hohen medizinischen Einsatz. Dabei besteht das Problem, den Schweregrad der Erkrankung nur unzureichend beschreiben zu können. Zudem genügt die aktuelle Datenlage noch nicht, um evidenzbasiert ein umfassendes, multimodales Behandlungskonzept aufstellen zu können. Das Topthema dieser AINS gibt einen Überblick über den aktuellen Forschungsstand und über neue Perspektiven in der ARDS–Behandlung.

Literaturverzeichnis

  • 1 Bernard G, Artigas A, Brigham K, Carlet J, Falke K, Hudson L, Lamy M, Legall J, Morris A, Spragg R.. The American–European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination.  Am J Respir Crit Care Med. 1994;  149 818-824
  • 2 Rubenfeld GD.. Epidemiology of acute lung injury.  Crit Care Med. 2003;  31
  • 3 Lewandowski K, Metz J, Deutschmann C, Preiss H, Kuhlen R, Artigas A, Falke KJ.. Incidence, severity, and mortality of acute respiratory failure in Berlin, Germany.  Am J Respir Crit Care Med. 1995;  151 1121-1125
  • 4 Brun–Buisson C, Minelli C, Bertolini G, Brazzi L, Pimentel J, Lewandowski K, Bion J, Romand JA, Villar J, Thorsteinsson A, Damas P, Armaganidis A, Lemaire F. ALIVE Study Group. . Epidemiology and outcome of acute lung injury in European intensive care units.  Intensive Care Med. 2004;  30 4-6
  • 5 Sachse S, Lehmann M, Schmitz R, Reinhart K, Straube E.. Multiplex PCR vs. Blood Culture: Towards a New Gold Standard in Sepsis Diagnostics.  Shock 2008. 2008;  29
  • 6 Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, Suppes R, Feinstein D, Zanotti S, Taiberg L, Gurka D, Kumar A, Cheang M.. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock.  Crit Care Med. 2006;  34 1589-1596
  • 7 The National Heart, Lung, and Blood Institue Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. . Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury ant the acute respiratory distress syndrome.  N Engl J Med. 2000;  342 1301-1308
  • 8 The National Heart, Lung, and Blood Institue Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. . Higher versus Lower Positive End–Exspiratory Pressures in Patients with the Acute Respiratory Distress Syndrome.  N Engl J Med. 2004;  351 327-336
  • 9 The National Heart, Lung, and Blood Institue Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. . Comparison of Two Fluid–Management Strategies in Acute Lung Injury.  N Engl J Med. 2006;  354 2564-2575
  • 10 The National Heart, Lung, and Blood Institue Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. . Pulmonary – artery versus central venous catheter to guide treatment of acute ling injury.  N Engl J Med. 2006;  354 213-224
  • 11 Villar J, Kacmarek RM, Perez–Mendez L, Armando A–J. Aries Network. . A high positive end–exspiratory pressure, low tidal volume ventilatory strategy improves outcome in persistent acute respiratory distress syndrome: A randomized, controlled trial.  Crit Care Med. 2006;  34 1311-1318
  • 12 Deja M, Hommel M, Weber–Carstens S, Moss M, von Dossow V, Sander M, Pille C, Spies C.. Evidence–based therapy of acute respiratory distress syndrome: an algorithm–guided approach.  J Int Med Res. 2008;  36 211-221
  • 13 Bersten AD, Edibam C, Hunt T, Moran J. Australian and New Zealand Intensive Care Society Clinical Trials Group. . Incidence and mortality of acute lung injury and the acute respiratory distress syndrome in three Australian States.  Am J Respir Crit Care Med. 2002;  165 443-448
  • 14 Chan KP, Stewart TE, Mehta S.. High frequency ventilation for adult patients with ARDS.  Chest. 2007;  131 1907-1916
  • 15 Beiderlinden M, Kuehl H, Boes T, Peters J.. Prevalence of pulmonary hypertension associated with severe acute respiratory distress syndrome: predictive value of computed tomography.  ICM. 2006;  32 1627-1631
  • 16 Luecke T. et al. . Predictors of mortality in ARDS patients referred to a tertiary care centre: a pilot study.  EJA. 2006;  23 403-410
  • 17 Zhang Y. et al. . Decreased release of nitric oxide (NO) by alveolar macrophages afterin vivo loading of rats with either iron or ethanol.  Biochem Pharmacol. 1998;  55 21-25
  • 18 Chang CY, Tucci M, Baker RC.. Lipopolysaccharide–stimulated nitric oxide production and inhibition of cell proliferation is antagonized by ethanol in a clonal macrophage cell line. et al.  Alcohol. 2000;  20 37-43
  • 19 Moss M, Burnham EL.. Chronic alcohol abuse, acute respiratory distress syndrome, and multiple organ dysfunction.  Crit Care Med. 2003;  31 207-212
  • 20 Calfee CS, Matthay MA.. Nonventilatory treatments for acute lung injury and ARDS.  Chest. 2007;  131 913-920
  • 21 Deja M, Denke C, Weber–Carstens S. et al. . Social support during intensive care unit stay might improve mental impairment and consequently health–related quality of life in survivors of severe acute respiratory distress syndrome.  Crit Care. 2006;  10

Dr. med. Maria Deja
Prof. Dr. med. Claudia Spies

Email: maria.deja@charite.de

Email: claudia.spies@charite.de

>