Anest. intenziv. Med. 2003;14(4):172-180

Rescue Therapeutical Procedures in Patients with Severe ARDSArticles

P. Dostál, R. Pařízková: Klinika anesteziologie, resuscitace a intenzivní medicíny, UK v Praze, LF v Hradci Králové, Fakultní nemocnice Hradec Králové, přednosta kliniky doc. MUDr. V. Černý, PhD., FCCM

Prognosis of patients suffering from acute respiratory distress syndrome (ARDS) remains uncertain with mortality rate20-60 %. Severe respiratory failure featuring profound hypoxemia resistant to conventional therapy may occur in somepatients. "Rescue therapy procedures" have been considered as treatment options mostly in experimental setting or instrictly defined and limited cohorts of patients. Selected experimental and clinical trials evaluating therapy with inhalednitric oxide, surfactant treatment, liquid ventilation, high frequency oscillation, extracorporeal lung assisting devices andprone position are discussed.Based on currently available results,prone position and high frequency oscillatory ventilationappear to be most promising and likely to become a part of standard therapy for selected subgroups of patients in the future.