Jornal de Pediatria
Print version ISSN 0021-7557
ROTTA, Alexandre Tellechea; KUNRATH, Cláudia Laura Barberio and WIRYAWAN, Budi. Management of the acute respiratory distress syndrome. J. Pediatr. (Rio J.) [online]. 2003, vol.79, suppl.2, pp. S149-S160. ISSN 0021-7557. http://dx.doi.org/10.1590/S0021-75572003000800004.
OBJECTIVE: To review the current support and treatment strategies of the Acute Respiratory Distress Syndrome (ARDS) DATA SOURCES: Original data from our research laboratory and from representative scientific articles on ARDS and acute lung Injury searched through Medline. SUMMARY OF THE FINDINGS: Despite advances in the understanding of the pathogenesis of ARDS, this syndrome still results in significant morbidity and mortality. Mechanical ventilation, the main therapeutic modality for ARDS, is no longer considered simply a support modality, but a therapy capable of influencing the course of the disease. New ventilation strategies, such as high-frequency oscillatory ventilation (HFOV) appear to be promising. This text reviews the current knowledge of ARDS management, including conventional and non-conventional ventilation, the use of surfactant, nitric oxide, modulators of inflammation, extracorporeal membrane oxygenation and prone position. CONCLUSIONS: The last decade was marked by significant advances, such as the concept of protective ventilation for ARDS. The benefit of alternative strategies, such as HFOV, the use of surfactant and immunomodulators continue to be the target of study.
Keywords : Acute respiratory distress syndrome; mechanical ventilation; high-frequency ventilation; surfactant; nitric oxide.