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British Journal of Anaesthesia 2004 93(3):322-324; doi:10.1093/bja/aeh202
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2004

Editorial II: High-frequency oscillation in acute respiratory distress syndrome (ARDS)

A. McLuckie

Department of Intensive Care, 1st Floor East Wing, Guy's and St Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK E-mail: Angela.McLuckie@gstt.sthames.nhs.uk

The first 150 words of the full text of this article appear below.

Over the past 15 years, the mortality associated with acute respiratory distress syndrome (ARDS) has steadily declined. In the late 1980s and early 1990s, ~33% of patients with the syndrome survived to leave hospital, compared with survival rates of 60–75% reported more recently.1–3 Although the explanation for this reduction is likely to be multifactorial, improvements in ventilation techniques have undoubtedly made a major contribution.

Current best-practice with regard to ventilation in ARDS is often described as ‘protective’ ventilation or the ‘open-lung’ approach, and involves recruitment manoeuvres to re-expand atelectatic areas of lung, followed by application of relatively high levels of positive end-expiratory pressure (PEEP) to prevent airway closure and alveolar collapse at end-expiration (atelectrauma). In addition, tidal volumes are limited to 6 ml kg–1 and plateau pressure to <30 cm H2O to avoid overdistension of the lung at end-inspiration (volutrauma).4 When this approach is followed, pulmonary and systemic cytokine . . . [Full Text of this Article]


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