ACUTE RESPIRATORY DISTRESS SYNDROME, ACUTE LUNG INJURY and SEPSIS
PRONING GUIDELINES
www0.sun.ac.za/Physiotherapy_ICU_algorithm/Documentation/ALI_ARDS/References/Ball_2001.pdf


Adhikari, NKJ, McAndrews MP, Tansey CM (2009) Self-reported symptoms of depression and memory dysfunction in survivors of ARDS. Chest, 135, 678-87
www.chestjournal.org/content/135/3/678.abstract
• ARDS survivors report a high prevalence of depression and a lower prevalence of memory dysfunction 6 to 48 months after ICU discharge; these may hinder the return to work

Athota KP, Millar D, Branson RD et al (2014) A practical approach to the use of prone therapy in acute respiratory distress syndrome. Expert Rev Respir Med; 8(4):453-63. doi: 10.1586/17476348.2014.918850

Aisiku IP, Yamal JM, Doshi P et al (2016) The incidence of ARDS and associated mortality in severe TBI using the Berlin definition. J Trauma Acute Care Surg; 80(2):308-12. doi: 10.1097/TA.0000000000000903
• severe brain injury is associated with an incidence of ARDS ranging from 20% to 25%

Athota KP, Millar D, Branson RD et al (2014) A practical approach to the use of prone therapy in acute respiratory distress syndrome. Expert Rev Respir Med; 8(4):453-63. doi: 10.1586/17476348.2014.918850

Baktoft B (2001) Nursing care of patients in the prone position. Crit Care Nurs Eur, 1, 83-6
• lots of practical information

Ball C, Adams J, Boyce S, Robinson P (2001) Clinical guidelines for the use of the prone position in ARDS. Int Crit Care Nurs, 17, 94-104
• flow chart and practicalities

Barker M, Adams S (2002) An evaluation of a single chest physiotherapy treatment on mechanically ventilated patients with acute lung injury. Physiother Res Int, 7, 3, 157-69
www3.interscience.wiley.com/journal/112501201/abstract
• PaO2:FiO2 ratio did not alter significantly with (a) suction, (b) positioning and suction, (c) positioning, MH and suction.

Beitler JR, Guérin C, Ayzac L et al (2015) PEEP titration during prone positioning for acute respiratory distress syndrome. Crit Care; 19:436. doi: 10.1186/s13054

Beitler JR, Majumdar R, Hubmayr RD et al (2016) Volume delivered during recruitment maneuver predicts lung stress in acute respiratory distress syndrome. Crit Care Med; 44(1):91-99

Bellani G, Laffey JG Pham T et al (2016) The LUNG SAFE study: a presentation of the prevalence of ARDS according to the Berlin Definition! Crit Care; 201620:268. doi: 10.1186/s13054-016-1443-x
ccforum.biomedcentral.com/articles/10.1186/s13054-016-1443-x

Bianchi AMI, Reboredo MM, Lucinda LMF et al (2016) The effects of prone position ventilation on experimental mild acute lung injury induced by intraperitoneal lipopolysaccharide injection in rats. Lung; 194(2):193-199. doi: 10.1007/s00408-016-9853-8
• prone is associated with lower lung inflammation and injury

Biehl M, Kashiouris MG, Gajic O (2013) Ventilator-induced lung injury: minimizing its impact in patients with or at risk for ARDS. Respir Care, 58, 6, 927-34

Biswas A (2015) Right heart failure in acute respiratory distress syndrome: An unappreciated albeit a potential target for intervention in the management of the disease. Indian J Crit Care Med; 19(10):606-609

Boyle AJ, Sweeney RM, McAuley DF (2013) Pharmacological treatments in ARDS; a state-of-the-art update. BMC Med; 11:166
www.biomedcentral.com/1741-7015/11/166
• β2-agonists should be avoided because of potentially harmful cardiac effects

Caltabeloti FP, Monsel A, Arbelot C et al (2014) Early fluid loading in acute respiratory distress syndrome with septic shock deteriorates lung aeration without impairing arterial oxygenation: a lung ultrasound observational study. Crit Care; 18:R91. doi:10.1186/cc13859
• ultrasound helps guard against excessive fluid loading

Cannon JW (2017) Optimal strategies for severe acute respiratory distress syndrome. Crit Care Clinics; 33(2):259-75
• ARDS) occurs in over 10% of ICU admissions and nearly 25% of ventilated patients

Carr J (2007) Psychological consequences associated with intensive care treatment. Trauma, 9, 95–102
• 70% of patients with sepsis suffer encephalopathy

Casserly B, McCool FD, Saunders J et al (2016) End-expiratory volume and oxygenation: targeting PEEP in ARDS patients. Lung; 194(1):35-41. doi. 10.1007/s00408-015-9823-6
link.springer.com/journal/408/194/1/page/1#page-1

Cárdenes N (2013) Mesenchymal stem cells: a promising therapy for the acute respiratory distress syndrome. Respiration; 85(4):267-278. doi: 10.1159/000347072

Cereda M, Xin Y, Meeder N et al (2016) Visualizing the propagation of acute lung injury. Anesthesiology; 124:121-131. doi:10.1097/ALN.0000000000000916

Chen IC, Kuo J, Ko WJ et al (2016) Increased flow resistance and decreased flow rate in patients with acute respiratory distress syndrome: The role of autonomic nervous modulation. J Chin Med Assoc; 79(1):17-24. doi: 10.1016/j.jcma.2015.10.001

Chiumello D, Coppola S, Froio S et al (2016) What's next after ARDS: long-term outcomes. Respir Care; 61(5):689-699
• hospital mortality averages 33% and long-term mortality ranges between 11 and 60%

Chiumello D, Brioni M (2016) Severe hypoxemia: which strategy to choose. Crit Care; 20:132
ccforum.biomedcentral.com/articles/10.1186/s13054-016-1304-7

Colmenero-Ruiz M (2001) Abdomen release in prone position does not improve oxygenation in an experimental model of acute lung injury. Int Care Med, 27, 566-73
• prone with a free abdomen does not improve gas exchange - but this may not apply to humans which are different to pigs

Coombes H (2001) The prone position for IPPV. ACPRC Journal, 34, 29-38
• practicalities

Cossu AP, Cossu M, De Giudici L (2013) ARDS: Who needs to be pronated? J Pulm Respir Med 3:153. doi: 10.4172/2161-105X.1000153
• proning reduces mortality

Cranshaw J, Griffiths MJD (2002) The pulmonary physician in critical care: non-ventilatory strategies in ARDS. Thorax, 57, 823-9
• fluids, drugs, immunonutrition, surfactant, antioxidants

Culbreth RE, Goodfellow LT (2016) Complications of prone positioning during extracorporeal membrane oxygenation for respiratory failure: a systematic review. Respir Care; 61(2):249-254

Das A, Cole O, Chikhani M et al (2015) Evaluation of lung recruitment maneuvers in acute respiratory distress syndrome using computer simulation. Crit Care; 19:8. doi: 10.1186/s13054-014-0723-6
www.ncbi.nlm.nih.gov/pmc/articles/PMC4329196/
• maintaining adequate post-RM levels of PEEP is crucial in avoiding cliff-edge re-collapse of alveoli

Dasenbrook EC, Needham DM, Brower RG et al (2011) Higher PEEP in patients with acute lung injury: a systematic review and meta-analysis. Respir Care, 56, 5, 568-75

Daurat A, Millet I, Roustan JP et al (2016) Thoracic Trauma Severity score on admission allows to determine the risk of delayed ARDS in trauma patients with pulmonary contusion. Injury; 47(1):147-53. doi: 10.1016/j.injury.2015.08.031

Drahnak DM, Custer N (2015) Prone positioning of patients with Acute Respiratory Distress Syndrome. Crit Care Nurse; 35(6):29-37. doi: 10.4037/ccn2015753

Dressler DK (2009) Death by clot: acute coronary syndromes, ischemic stroke, pulmonary embolism, and disseminated intravascular coagulation. AACN Adv Crit Care, 20, 2, 166-176
www.aacnadvancedcriticalcare.com/pt/re/aacn/abstract.01256961-200904000-00010.htm;jsessionid=KvrH4L602cm24lWhp9Mh7DyVTbFPK10s2S2BKdQLDR0cwRph3TWR!1966694724!181195629!8091!-1

Dreyfuss D, Ricard JD, Gaudry S (2015) Did studies on HFOV fail to improve ARDS survival because they did not decrease VILI? On the potential validity of a physiological concept enounced several decades ago. Intensive Care Med; 41(12):2076-86. doi: 10.1007/s00134-015-4062-0
• high frequency oscillation may be damaging with ARDS because high volumes can be generated and cause volutrauma

Dumont T, Francis-Frank L, Chong J et al (2016) Sepsis and septic shock: lingering questions. Crit Care Nurs Q; 39(1):3-13. doi: 10.1097/CNQ.0000000000000091

Fabiano DM (2010) Positive end-expiratory pressure-induced functional recruitment in patients with acute respiratory distress syndrome. Crit Care Med, 38, 1,127-32

Fan W, Nakazawa K, Abe S et al (2013) Inhaled aerosolized insulin ameliorates hyperglycemia-induced inflammatory responses in the lungs in experimental model of acute lung injury. Crit Care, 17, R83. doi:10.1186/cc12697

Fan E, Dowdy DW, Colantuoni E et al (2013) Physical complications in acute lung injury survivors: a 2-year longitudinal prospective study. Crit Care Med; 42(4):849-59

Fanelli V, Ranieri M, Mancebo J et al (2016) Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress syndrome. Crit Care; 20:36. doi: 10.1186/s13054-016-1211-y

Fessler HE (2010) Should prone positioning be routinely used for lung protection during mechanical ventilation? Respir Care, 55, 1, 88-99

Fioretto JR, Campos RJ, Ronchi CF et al (2012) Effects of inhaled nitric oxide on oxidative stress and histopathological and inflammatory lung injury in a saline-lavaged rabbit model of acute lung injury. Respir Care, 57, 2, 273-81

Fougères E, Teboul JL, Richard C, Osman D, Chemla D, Monnet X (2010) Hemodynamic impact of a positive end-expiratory pressure setting in acute respiratory distress syndrome: importance of the volume status. Crit Care Med, 38, 802-7.
• passive leg elevation as a substitute for fluid loading to restore cardiac output if it has been compromised by high PEEP

Gattinoni L, Quintel M (2016) How ARDS should be treated. Crit Care; 20:86. doi: 10.1186/s13054-016-1268-7
ccforum.biomedcentral.com/articles/10.1186/s13054-016-1268-7

Gaudry S, Tuffet S, Lukaszewicz AC et al (2017) Prone positioning in acute respiratory distress syndrome after abdominal surgery: a multicenter retrospective study. Annals Int Care; 7:21. doi: 10.1186/s13613-017-0235-z

Go L, Budinger GR, Kwasny MJ et al (2016) Failure to improve the oxygenation index is a useful predictor of therapy failure in acute respiratory distress syndrome clinical trials. Crit Care Med; 44(1):e40-4. doi: 10.1097/CCM.0000000000001295

Goettler CE (2002) Brachial plexopathy after prone positioning. Crit Care, 6, 540-2
• mechanisms, prevention

Gomaa Dina, Branson RD (2015) Endotracheal tube holders and the prone position: a cause for concern (letter). Respir Care; 60(2):1315-1323

Gong MN, Thompson BT (2016) Acute respiratory distress syndrome: shifting the emphasis from treatment to prevention. Curr Opin Crit Care; 22(1):21-37. doi: 10.1097/MCC.0000000000000275

Grawe ES, Bennett S, Hurford WE (2016) Early paralysis for the management of ARDS. Respir Care; 61(6):830-838

Guervilly C (2013) Prone positioning during veno venous extra corporeal membrane oxygenation for severe acute respiratory distress syndrome in adults. Minerva Anestesiol; 80(3):307-13

Güldner A, Pelosi P, Gama de Abreu M (2014) Spontaneous breathing in mild and moderate versus severe acute respiratory distress syndrome. Curr Opin Crit Care.; 20(1):69-76. doi: 10.1097/MCC.0000000000000055
• people with severe ARDS benefit from CMV in the initial stages to protect lung tissue

Herridge MS, Moss M, Hough CL et al (2016) Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers. Int Care Med; 42(5):725-38. doi: 10.1007/s00134-016-4321-8
• ICU-acquired weakness is ubiquitous and recovery may be incomplete 5 years after discharge
• Cognitive impairment ranges from 70 to 100% at discharge, 46 to 80% at 1 year, and 20% at 5 years, and depression and PTSD are sustained and prevalent

Hess DR (2015) Recruitment maneuvers and PEEP titration. Respir Care; 60(11):1688-1704
• proning is a form of recruitment manoeuvre by opening previously-closed alveoli

Hodgson CL et al (2012)Long-term quality of life in patients with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation for refractory hypoxaemia. Critical Care, 16:R202 doi:10.1186/cc11811

Hoegl S, Zwissler B, Eltzschig HK et al (2016) Acute respiratory distress syndrome following cardiovascular surgery: current concepts and novel therapeutic approaches. Curr Opin Anaesthesiol; 29(1):94-100. doi: 10.1097/ACO.0000000000000283

Horie S, Masterson C, Devaney J et al (2016) Stem cell therapy for acute respiratory distress syndrome: a promising future? Curr Opin Crit Care; 22(1):14-20. doi: 10.1097/MCC.0000000000000276

Huang X, Cui J (2015) Effect of sustained inflation with different degrees of negative pressure for sputum aspiration in patients with acute respiratory distress syndrome on lung recruitment. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue; 27(7):606-10. doi: 10.3760/cma.j.issn.2095-4352.2015.07.013

Ichikado K, Muranaka H, Gushima Y et al (2012) Fibroproliferative changes on high-resolution CT in the acute respiratory distress syndrome predict mortality and ventilator dependency: a prospective observational cohort study. BMJ Open, 2, 2, e000545
www.ncbi.nlm.nih.gov/pmc/articles/PMC3293132/?tool=pmcentrez

Kacmarek RM, Villar J, Sulemanji D et al (2016) Open lung approach for the acute respiratory distress syndrome: a pilot, randomized controlled trial. Crit Care Med; 44(1):32-42
• open lung strategies with decremental PEEP can improve oxygenation without barotrauma

Kallet RH (2015) A comprehensive review of prone position in ARDS
Respir Care; 60(11):1660-87. doi: 10.4187/respcare.04271.

Kangelaris KN, Ware LB, Wang CY et al (2016) Timing of intubation and clinical outcomes in adults with acute respiratory distress syndrome. Crit Care Med; 44(1):120-129

Kao K-C, Hu H-C, Hsieh M-J et al (2015) Comparison of community-acquired, hospital-acquired, and intensive care unit-acquired acute respiratory distress syndrome: a prospective observational cohort study. Crit Care; 19:384
ccforum.biomedcentral.com/articles/10.1186/s13054-015-1096-1

Khan A (2010) Recruitment maneuvers in ARDS... more questions than answers. Chest, 137, 3, 737

Kim RS, Mullins K (2016) Preventing facial pressure ulcers in acute respiratory distress syndrome (ARDS). J Wound, Ostomy Continence Nurs; 43(4):427- 9
• silicone foam dressings on pressure areas between tracheal tube and skin

Kimmoun A, Roche S, Bridey C et al (2015) Prolonged prone positioning under VV-ECMO is safe and improves oxygenation and respiratory compliance. Ann Intensive Care; 5(1):35. doi: 10.1186/s13613-015-0078-4

Koulouras V, Papathanakos G, Papathanasiou A et al (2016) Efficacy of prone position in acute respiratory distress syndrome patients: A pathophysiology-based review. World J Crit Care Med; 5(2):121-136. doi: 10.5492/wjccm.v5.i2.121.
www.ncbi.nlm.nih.gov/pmc/articles/PMC4848155/
• there are few patients, who after being turned to the prone position show no improvement
• prone should be as early as possible when oedema, lung recruitability, and absence of structural alterations of the lung are most represented
prone not as a rescue manoeuver or a last-ditch effort
• 12-36 hour sessions, with brief daily periods in supine for nursing care

Kreyer S, Muders T, Luepschen H et al (2014) Pumpless extracorporeal CO2 removal restores normocapnia and is associated with less regional perfusion in experimental acute lung injury. Acta Anaesthesiol Scand; 58(1):52–60. doi: 10.1111/aas.12217

Kreyer S, Scaravilli V, Linden K et al (2016) Early utilization of extracorporeal CO2 removal for treatment of acute respiratory distress syndrome due to smoke inhalation and burns in sheep. Shock; 45(1):65-72. doi: 10.1097/SHK.0000000000000471

Laffey JG (2013) Predicting the development of Acute Respiratory Distress Syndrome: searching for the "troponin of ARDS". Am J Respir Crit Care Med, 187, 7, 671-2.

Lai P (2013) What is the clinical significance of pulmonary hypertension in acute respiratory distress syndrome? A review. Minerva Anestesiol; 80(5):574-85 www.ncbi.nlm.nih.gov/pubmed/24193181

Lamontagne F, Brower R, Meade M (2013) Corticosteroid therapy in acute respiratory distress syndrome. Can Med Ass J, 185. 3, 216-21

L’Her E et al (2002) A prospective survey of early 12-hour positioning effects in patients with ARDS. Int Care Med, 28, 570-5
• 12-hour proning is beneficial and safe

Liu S, Tan L, Möller K et al (2016) Identification of regional overdistension, recruitment and cyclic alveolar collapse with electrical impedance tomography in an experimental ARDS model. Crit Care; 20:119
ccforum.biomedcentral.com/articles/10.1186/s13054-016-1300-y

López-Aguilar J, Lucangelo U, Albaiceta GM et al (2015) Effects on lung stress of position and different doses of perfluorocarbon in a model of ARDS. Respir Physiol Neurobiol; 210:30-7. doi: 10.1016/j.resp.2015.01.016

Maggiore SM (2003) Prevention of endotracheal suctioning-induced alveolar derecruitment in acute lung injury. Am Rev Resp Crit Care Med, 167, 1215-24.
• suction-induced atelectasis in acute lung injury can be prevented by a recruitment manoeuvre (pressure support at 40 cm H2O) during suction, and minimized by avoiding disconnection

Mancebo J (2006) A multicenter trial of prolonged prone ventilation in severe ARDS. Am J Respi.Crit.Care Med, 173, 1233-9
ajrccm.atsjournals.org/cgi/content/abstract/173/11/1233
• at last someone brave enough to prone their patients early enough and long enough

Marini JJ (2011) Recruitment by sustained inflation: time for a change. Int Care Med; 37(10):1572–1574
• the potential damage of ventilator hyperinflation may be lessened by increasing pressure gradually

Marini JJ, Josephs SA, Mechlin M et al (2016) Should early prone positioning be a standard of care in ARDS with refractory hypoxemia? Respir Care; 61(6):818-829

Martin I (2013) Effectiveness of an inspiratory pressure-limited approach to mechanical ventilation in septic patients. Europ Resp J, 41, 1, 157-164. doi: 10.1183/09031936.00221611

MacIntyre NR (2008) Is there a best way to set positive expiratory-end pressure for mechanical ventilatory support in acute lung injury? Clin.Chest Med, 29, 2, 233-239
• manipulating PEEP to maintain alveolar patency without overdistending healthier lung regions or compromising cardiac function.

Marini JJ (2016) Should we embrace the “open lung” approach? Crit Care Med; 44(1):237–238. doi: 10.1097/CCM.0000000000001489

McAuley D, Giles S, Fichter H (2002) What is the optimal duration of ventilation in the prone position in acute lung injury and acute respiratory distress syndrome? Int Care Med, 28, 4, 414-8
• progressive improvement is expected for prolonged periods

Messerole E et al (2002) The pragmatics of prone positioning. Am J Resp Crit Care Med, 165, 1359-63
• succint explanation of the rationale of proning in ARDS + useful algorithm on the procedure

Messika J, Ahmed KB, Gaudry S et al (2015) Use of high-flow nasal cannula oxygen therapy in subjects with ARDS: a 1-year observational study. Respir Care; 60(2):162-169

Michaels AJ, Hill JG, Sperley BP et al (2015) Use of HFPV for adults with ARDS: the protocolized use of high-frequency percussive ventilation for adults with acute respiratory failure treated with extracorporeal membrane oxygenation. Am Soc for Artificial Internal Organs J; 61(3):345-9. doi: 10.1097/MAT.0000000000000196
• ‘lung rest’ for people with ARDS

Millar FR, Summers C, Griffiths MJ et al (2016) The pulmonary endothelium in acute respiratory distress syndrome: insights and therapeutic opportunities. Thorax; 71(5):462-473. doi: 10.1136/thoraxjnl-2015-207461

Moloney ED, Griffiths MJD (2004) Protective ventilation of patients with acute respiratory distress syndrome. Br J Anaesth, 92, 261–70
www.bja.oupjournals.org/cgi/content/abstract/92/2/261
• mechanism of inflammatory response to injured and overdistended lung, and prevention

Mols G, Priebe HJ, Guttmann J (2006) Alveolar recruitment in acute lung injury. Br J Anaesth, 96 (2), 156-66
bja.oxfordjournals.org/cgi/content/full/96/2/156?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=96&firstpage=156&resourcetype=HWCIT
• clear and balanced explanation of alveolar recruitment

Morán I (2006) Heat and moisture exchangers and heated humidifiers in ALI/ARDS patients. Int Care Med, 32, 4, 524-31
springerlink.metapress.com/(4nt0hn55kegoqri5o1po2rub)/app/home/contribution.asp?referrer=parent&backto=issue,7,37;journal,4,297;browsepublicationsresults,615,1574
• heated humidifier reduces dead space and decreases PaCO2 so that tidal volume can be lowered, which improves respiratory system compliance and reduces plateau airway pressure

Müller-Redetzky HC, Will D, Hellwig K et al (2014) Mechanical ventilation drives pneumococcal pneumonia into lung injury and sepsis in mice: protection by adrenomedullin. Crit Care; 18:R73. doi:10.1186/cc13830
• the endogenous peptide adrenomedullin may prevent pneumonia developing into ARDS

Ochiai R (2015) Mechanical ventilation of acute respiratory distress syndrome. J Int Care; 3:25. doi:10.1186/s40560-015-0091-6
• there is no safe limit for driving pressure on the ventilator
• recruitment manoeuvres improve SpO2 but not survival, and may over-distend normal lung tissue
• mortality 30–40 %
www.jintensivecare.com/content/3/1/25/?utm_campaign=BMC22960C&utm_medium=BMCemail&utm_source=Teradata

Offner PJ (2000) Complications of prone ventilation with multisystem trauma and ARDS. J Trauma Injury Inf Crit Care, 48, 224-8

O'Gara B, Fan E, Talmor DS (2015) Controversies in the management of severe ARDS: optimal ventilator management and use of rescue therapies. Semin Respir Crit Care Med; 36(6):823-34. doi: 10.1055/s-0035-1564889
prone positioning needs to be instigated early enough and for long enough

Panchabhai TS, Bandyopadhyay D, Kapoor A et al (2016) Acute ischemic optic neuropathy with extended prone position ventilation in a lung transplant recipient. Int J Crit Illn Inj Sci; 6(1):45-7. doi: 10.4103/2229-5151.177367.
www.ijciis.org/article.asp?issn=2229-5151;year=2016;volume=6;issue=1;spage=45;epage=47;aulast=Panchabhai
• prone may cause vision loss

Paternot A, Repesse X, Vieillard-Baron A et al (2016) Rationale and description of right ventricle-protective ventilation in ARDS. Respir Care; 61(10):1391-1396

Payen D (2013) Immunotherapy - a potential new way forward in the treatment of sepsis. Crit Care, 17, 118. doi:10.1186/cc12490

Pesenti A, Musch G, Lichtenstein D et al (2016) Imaging in acute respiratory distress syndrome. Intensive Care Med; 42(5):686-98. doi: 10.1007/s00134-016-4328-1

Pfurtscheller K, Ring S, Beran E et al (2015) Effect of body position on ventilation distribution during PEEP titration in a porcine model of acute lung injury using advanced respiratory monitoring and electrical impedance tomography. Int Care Med Exp; 3(1):38. doi: 10.1186/s40635-014-0038-6
• prone positioning promotes homogenous ventilation

Pierrakos C, Karanikolas M, Scolletta S et al (2012) Acute Respiratory Distress Syndrome: pathophysiology and therapeutic options. J Clin Med Res, 4, 1, 7–16
www.ncbi.nlm.nih.gov/pmc/articles/PMC3279495/?tool=pmcentrez

Porto EF, Tavolaro KC, Kumpel C et al (2016) Comparative analysis between the alveolar recruitment maneuver and breath stacking technique in patients with acute lung injury. Rev Bras Ter Intensiva; 26(2):163-8
www.ncbi.nlm.nih.gov/pmc/articles/PMC4103943/

Przybysz TM, Heffner AC (2016) Early treatment of severe acute respiratory distress syndrome Emerg Med Clin; 34(1):1–14
• mortality is 27-45%

Räsänen J, Nemergut ME, Gavriely N (2014) Changes in breath sound power spectra during experimental oleic acid-induced lung injury in pigs. J Appl Phys; 116(1):61-66. doi: 10.1152/japplphysiol.00651.2013

Richter T (2005) Effect of prone position on regional shunt, aeration, and perfusion in experimental acute lung injury. Am J Respir Crit Care Med, 172, 4, 480–487
www.ncbi.nlm.nih.gov/pmc/articles/PMC2718529/?tool=pmcentrez

Rodriguez PO, BOnelli I, Setten M et al (2013) Transpulmonary pressure and gas exchange during decremental PEEP titration in pulmonary ARDS patients. Respir Care, 58, 5, 754-63

Rowe C (2004) Development of clinical guidelines for prone positioning in critically ill adults. Nurs Crit Care, 9, 50-57
• everything you need to know about the practicalities

Roy SK, Emr B, Sadowitz B et al (2013) Preemptive application of Airway Pressure Release Ventilation (APRV) prevents development of Acute Respiratory Distress Syndrome (ARDS) in a rat traumatic hemorrhagic shock model. Shock; 40(3):210-6. doi: 10.1097/SHK.0b013e31829efb06

Rylander C (2005) Uneven distribution of ventilation in acute respiratory distress syndrome. Crit.Care, 9, R165-R171
ccforum.com/content/9/2/R165/abstract
• about one-third of the gas volume is delivered to poorly ventilated or non-ventilated areas

Saez de la Fuente I et al (2016) Enteral nutrition in patients receiving mechanical ventilation in a prone position. JPEN J Parenter Enteral Nutr; 40(2):250-5. doi: 10.1177/0148607114553232

Santiago VR, Rzezinski AF, Nardelli LM et al (2010) Recruitment maneuver in experimental acute lung injury: the role of alveolar collapse and edema. Crit Care Med; 38(11):2207-14. doi: 10.1097/CCM.0b013e3181f3e076
• recruitment maneuvers may worsen lung function and potentiate epithelial injury

Santos RS, Silva PL, Pelosi P et al (2015) Recruitment maneuvers in acute respiratory distress syndrome: The safe way is the best way. World J Crit Care Med; 4(4):278-86. doi: 10.5492/wjccm.v4.i4.278

Sarge T (2014) Raising positive end-expiratory pressures in ARDS to achieve a positive transpulmonary pressure does not cause hemodynamic compromise. Inten Care Med; 40(1):126-8

Scholten EL, Beitler JR, Prisk G et al (2017) Treatment of ARDS with prone positioning. Chest; 151(1):215-224. doi:10.1016/j.chest.2016.06.032.
• prone improves survival

Schwaiberger D, Karcz M, Menk M et al (2016) Respiratory failure and mechanical ventilation in the pregnant patient. Crit Care Clinics; 32(1):85–95. doi: dx.doi.org/10.1016/j.ccc.2015.08.001

Silva S, Teboul JL (2011) Defining the adequate arterial pressure target during septic shock: not a 'micro' issue but the microcirculation can help. Crit Care,15, 6, 100
ccforum.com/content/15/6/1004/abstract
• maintain mean arterial pressure of at least 65 mmHg to maintain organ perfusion

Simon M, Braune S, Laqmani A et al (2016) Value of computed tomography of the chest in subjects with ARDS: a retrospective observational study. Respir Care; 61(3): 316-323. doi: 10.4187/respcare.04308

Spieth PM, Zhang H (2014) Pharmacological therapies for acute respiratory distress syndrome. Curr Opin Crit Care; 20(1):113-21. doi: 10.1097/MCC.0000000000000056

Talmor D, Sarge T, Malhotra A et al (2008) Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med, 359, 20, 2095-2104.

Thees C, Kaiser M, Scholz M (2007) Cerebral haemodynamics and carbon dioxide reactivity during sepsis syndrome. Crit Care, 11, R123
ccforum.com/content/11/6/R123
• most patients with sepsis develop potentially irreversible cerebral dysfunction

Vasudevan VP (2016) Rescue strategies in severe refractory hypoxemic respiratory failure: taking a step back. Respir Care; 61(2):255-257

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ACPRC = Association of Chartered Physiotherapists in Respiratory Care
ALI – acute lung injury (sometimes a precursor to the more serious ARDS)
ARDS = acute respiratory distress syndrome
IPPV = intermittent positive pressure ventilation, i.e. mechanical ventilation
MH = manual hyperinflation
PaO2:FIO2 = ratio of PaO2 to inspired oxygen
PEEP = positive end-expiratory pressure
PTSD = posttraumatic stress disorder
RM = recruitment manoeuvre
VA/Q = ventilation-perfusion ratio