Approaches and techniques to avoid development or progression of acute respiratory distress syndrome

Beloncle, François; Mercat, Alain

doi:10.1097/mcc.0000000000000477

Cited by 8 publications

(9 citation statements)

References 54 publications

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“…5,6 Despite considerable research efforts, established therapeutic strategies for ARDS are limited. 7 Antiplatelet drugs, including aspirin and P2Y12 receptor inhibitors, are commonly used for secondary prevention of atherothrombotic events in patients with cardiovascular diseases. Aspirin and clopidogrel (P2Y12 receptor inhibitor) also reduce systemic inflammation and platelet-leukocyte coagulation, both of which are implicated in ARDS pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

Effects of Pre-Hospital Antiplatelet Therapy on the Incidence of ARDS

et al. 2020

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BACKGROUND: Clinical observations on the potential of pre-hospital antiplatelet therapy in preventing ARDS have been inconsistent. To further the correlation between antiplatelet therapy and ARDS, we conducted a meta-analysis to evaluate the effects of pre-hospital antiplatelet therapy on subjects with ARDS. METHODS: A literature search in major data banks was performed. We included prospective and retrospective cohorts, case-control trials, and randomized controlled trials that compared the ARDS incidence in subjects with or without pre-hospital antiplatelet agents. RESULTS: Meta-analysis of 7 studies (a total of 30,291 subjects) showed significantly lower odds of ARDS in the pre-hospital antiplatelet therapy group compared with subjects with no pre-hospital antiplatelet therapy (odds ratio 0.68, 95% CI 0.56-0.83; P < .001). However, ARDS mortalities in the hospital and ICUs were not affected. CONCLUSIONS: These findings indicated that pre-hospital antiplatelet therapy was associated with a reduced rate of ARDS but had no effect on the mortality in the subjects at high risk.

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Section: Introductionmentioning

confidence: 99%

Effects of Pre-Hospital Antiplatelet Therapy on the Incidence of ARDS

et al. 2020

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“…Systemic corticosteroids may alleviate the inflammation and lung edema, but ideally should be used for as short duration of treatment as possible 25 . Clinical studies demonstrated that corticosteroid was applied to 28 (20%) patients with severe COVID‐19 infection, for example, methylprednisolone at 40–80 mg daily for 5 days on average (IQR: 3–8 days) 1,6 .…”

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confidence: 99%

“…There is still an urgent need for specific therapy for ALI/ARDS, since almost all promising candidates have failed to prove beneficial in clinical trials 25 . For example, Cisatracurium as one of neuromuscular blockers failed to improve the prognosis of patients with ARDS in several clinical trials 26 .…”

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confidence: 99%

Acute lung injury in patients with COVID‐19 infection

Huang

Wang

et al. 2020

Clinical & Translational Med

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During the 2020 Spring Festival in China, the outbreak of a novel coronavirus, named COVID‐19 by WHO, brought on a worldwide panic. According to the clinical data of infected patients, radiologic evidence of lung edema is common and deserves clinical attention. Lung edema is a manifestation of acute lung injury (ALI) and may progress to hypoxemia and potentially acute respiratory distress syndrome (ARDS). Patients diagnosed with ARDS have poorer prognosis and potentially higher mortality. Although no effective treatment is formally approved for COVID‐19 infection, support of ventilation with oxygen therapy and sometimes mechanical ventilation is often required. Treatment with systemic and/or local glucocorticoids might be helpful to alleviate the pulmonary inflammation and edema, which may decrease the development and/or consequences of ARDS. In this article, we focus on the lung edema and ALI of patients with this widely transmitted COVID‐19 infection in order to provide clinical indications and potential therapeutic targets for clinicians and researchers.

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“…Increasing recognition of the adverse effects related to fluid overload in the ICU has led to more widespread adoption of conservative fluid management strategies ( 2 , 5 ). Patients with the acute respiratory distress syndrome (ARDS) are particularly vulnerable to adverse effects of fluid overload ( 6 – 8 ). Yet important knowledge gaps remain, including the optimal technique to assess overall volume status in ARDS ( 9 ).…”

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confidence: 99%