Title
Author
DOI
Article Type
Special Issue
Volume
Issue
New insights in mechanical ventilation and adjunctive therapies in ARDS
1Anesthesia and Intensive Care, San Martino Policlinico Hospital, 16132 Genoa, Italy
2Department of Medicine, University of Barcelona (UB), 08001 Barcelona, Spain
3Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, 21941-902 Rio de Janeiro, Brazil
4Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genoa, M5R 1C1 Genoa, Italy
DOI: 10.22514/sv.2022.035 Vol.18,Issue 5,September 2022 pp.1-11
Submitted: 08 February 2022 Accepted: 23 March 2022
Published: 08 September 2022
*Corresponding Author(s): Denise Battaglini E-mail: [email protected]
*Corresponding Author(s): Paolo Pelosi E-mail: [email protected]
† These authors contributed equally.
Patients with acute respiratory distress syndrome (ARDS) often require mechanical ventilation (MV) and may experience high morbidity and mortality. The ventilatory management of ARDS patients has changed over the years to mitigate the risk of ventilator-induced lung injury (VILI) and improve outcomes. Current recommended MV strategies include the use of low tidal volume (VT) at 4–6 mL/kg of predicted body weight (PBW) and plateau pressure (PPLAT ) below 27 cmH2O. Some patients achieve better outcomes with low VT than others, and several strategies have been proposed to individualize VT , including standardization for end-expiratory lung volume or inspiratory capacity. To date, no strategy for individualizing positive-end expiratory pressure (PEEP) based on oxygenation, recruitment, respiratory mechanics, or hemodynamics has proven superior for improving survival. Driving pressure, transpulmonary pressure, and mechanical power have been proposed as markers to quantify risk of VILI and optimize ventilator settings. Several rescue therapies, including neuromuscular blockade, prone positioning, recruitment maneuvers (RMs), vasodilators, and extracorporeal membrane oxygenation (ECMO), may be considered in severe ARDS. New ventilator strategies such as airway pressure release ventilation (APRV) and time-controlled adaptive ventilation (TCAV) have demonstrated potential benefits to reduce VILI, but further studies are required to evaluate their clinical relevance. This review aims to discuss the cornerstones of MV and new insights in ARDS ventilatory management, as well as their rationales, to guide the physician in an individually tailored rather than a fixed, sub-physiological approach. We recommend that MV be individualized based on physiological targets to achieve optimal ventilatory settings for each patient.
Mechanical ventilation; ARDS; COVID-19; Mechanical power; APRV
Denise Battaglini,Patricia Rieken Macedo Rocco,Paolo Pelosi. New insights in mechanical ventilation and adjunctive therapies in ARDS. Signa Vitae. 2022. 18(5);1-11.
[1] Ashbaugh D, Boyd Bigelow D, Petty T, Levine B. Acute respiratory distress in adults. Lancet. 1967; 290: 319–323.
[2] Cochi SE, Kempker JA, Annangi S, Kramer MR, Martin GS. Mortality trends of acute respiratory distress syndrome in the United States from 1999 to 2013. Annals of the American Thoracic Society. 2016; 13: 1742–1751.
[3] Laffey JG, Bellani G, Pham T, Fan E, Madotto F, Bajwa EK, et al. Potentially modifiable factors contributing to outcome from acute respiratory distress syndrome: the LUNG SAFE study. Intensive Care Medicine. 2016; 42: 1865–1876.
[4] Pelosi P, Ball L, Barbas CSV, Bellomo R, Burns KEA, Einav S, et al. Personalized mechanical ventilation in acute respiratory distress syndrome. Critical Care. 2021; 25: 250.
[5] Putensen C, Theuerkauf N, Zinserling J, Wrigge H, Pelosi P. Meta-analysis: ventilation strategies and outcomes of the acute respiratory distress syndrome and acute lung injury. Annals of Internal Medicine. 2009; 151: 566.
[6] Brower R, Matthay M, Morris A, Schoenfeld D, Thompson BT, Wheeler A. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The New England Journal of Medicine. 2000; 342: 1301–1308.
[7] Fan E, Del Sorbo L, Goligher EC, Hodgson CL, Munshi L, Walkey AJ, et al. An official american thoracic Society/European society of intensive care medicine/society of critical care medicine clinical practice guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine. 2017; 195: 1253–1263.
[8] Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA. 2016; 315: 788.
[9] Slutsky AS. History of mechanical ventilation. from vesalius to ventilator-induced lung injury. American Journal of Respiratory and Critical Care Medicine. 2015; 191: 1106–1115.
[10] Goligher EC, Costa ELV, Yarnell CJ, Brochard LJ, Stewart TE, Tomlinson G, et al. Effect of lowering Vt on mortality in acute respiratory distress syndrome varies with respiratory system elastance. American Journal of Respiratory and Critical Care Medicine. 2021; 203: 1378–1385.
[11] Hubmayr RD. Point: Is low tidal volume mechanical ventilation preferred for all patients on ventilation? Yes. Chest. 2011; 140: 9–11.
[12] Gattinoni L, Marini JJ, Pesenti A, Quintel M, Mancebo J, Brochard L. The “baby lung” became an adult. Intensive Care Medicine. 2016; 42: 663–673.
[13] Walkey AJ, Goligher EC, Del Sorbo L, Hodgson CL, Adhikari NKJ, Wunsch H, et al. Low tidal volume versus non–volume-limited strategies for patients with acute respiratory distress syndrome. A systematic review and meta-analysis. Annals of the American Thoracic Society. 2017; 14: S271–S279.
[14] Briel M, Meade M, Mercat A, Brower RG, Talmor D, Walter SD, et al. Higher vs. lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome. JAMA. 2010; 303: 865.
[15] Goligher EC, Kavanagh BP, Rubenfeld GD, Adhikari NK, Pinto R, Fan E, et al. Oxygenation response to positive end-expiratory pressure predicts mortality in acute respiratory distress syndrome. A secondary analysis of the lovs and express trials. American Journal of Respiratory and Critical Care Medicine. 2014; 190: 70–76.
[16] Cavalcanti AB, Suzumura ÉA, Laranjeira LN, Paisani DM, Damiani LP, Guimarães HP, et al. Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) vs. low PEEP on mortality in patients with acute respiratory distress syndrome. JAMA. 2017; 318: 1335.
[17] Hodgson CL, Cooper DJ, Arabi Y, King V, Bersten A, Bihari S, et al. Maximal recruitment open lung ventilation in acute respiratory distress syndrome (PHARLAP). A Phase II, multicenter randomized controlled clinical trial. American Journal of Respiratory and Critical Care Medicine. 2019; 200: 1363–1372.
[18] Mercat A, Richard J-CM, Vielle B, Jaber S, Osman D, Diehl JL, et al. Positive end-expiratory pressure setting in adults with acute lung injury and acute respiratory distress syndrome. JAMA. 2008; 299: 646.
[19] Brower RG, Lanken PN, MacIntyre N, Matthay MA, Morris A, Ancukiewicz M, et al. Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome. The New England Journal of Medicine. 2004; 351: 327–336.
[20] Meade MO, Cook DJ, Guyatt GH, Slutsky AS, Arabi YM, Cooper DJ, et al. Ventilation strategy using low tidal volumes, recruitment maneuvers, and high positive end-expiratory pressure for acute lung injury and acute respiratory distress syndrome. JAMA. 2008; 299: 637.
[21] Sahetya SK, Goligher EC, Brower RG. Fifty years of research in ards. setting positive end-expiratory pressure in acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine. 2017; 195: 1429–1438.
[22] Ball L, Serpa Neto A, Trifiletti V, Mandelli M, Firpo I, Robba C, et al. Effects of higher PEEP and recruitment manoeuvres on mortality in patients with ARDS: a systematic review, meta-analysis, meta-regression and trial sequential analysis of randomized controlled trials. Intensive Care Medicine Experimental. 2020; 8: 39.
[23] Papazian L, Aubron C, Brochard L, Chiche JD, Combes A, Dreyfuss D, et al. Formal guidelines: management of acute respiratory distress syndrome. Annals of Intensive Care. 2019; 9: 69.
[24] Dianti J, Tisminetzky M, Ferreyro BL, Englesakis M, Del Sorbo L, Sud S, et al. Association of PEEP and lung recruitment selection strategies with mortality in acute respiratory distress syndrome: a systematic review and network meta-analysis. To be published in American Journal of Respiratory and Critical Care Medicine. 2022. [Preprint].
[25] Chiumello D, Cressoni M, Carlesso E, Caspani ML, Marino A, Gallazzi E, et al. Bedside selection of positive end-expiratory pressure in mild, moderate, and severe acute respiratory distress syndrome. Critical Care Medicine. 2014; 42: 252–264.
[26] Chen L, Del Sorbo L, Grieco DL, Junhasavasdikul D, Rittayamai N, Soliman I, et al. Potential for lung recruitment estimated by the recruitment-to-inflation ratio in acute respiratory distress syndrome. A clinical trial. American Journal of Respiratory and Critical Care Medicine. 2020; 201: 178–187.
[27] Barrot L, Asfar P, Mauny F, Winiszewski H, Montini F, Badie J, et al. Liberal or conservative oxygen therapy for acute respiratory distress syndrome. The New England Journal of Medicine. 2020; 382: 999–1008.
[28] Battaglini D, Sottano M, Ball L, Robba C, Rocco PRM, Pelosi P. Ten golden rules for individualized mechanical ventilation in acute respiratory distress syndrome. Journal of Intensive Medicine. 2021; 1: 42–51.
[29] Battaglini D, Brunetti I, Anania P, Fiaschi P, Zona G, Ball L, et al. Neurological manifestations of severe SARS-CoV-2 infection: potential mechanisms and implications of individualized mechanical ventilation settings. Frontiers in Neurology. 2020; 11: 845.
[30] Bouferrache K, Vieillard-Baron A. Acute respiratory distress syndrome, mechanical ventilation, and right ventricular function. Current Opinion Critical Care. 2011; 17: 30–35.
[31] Zhao Z, Chang MY, Chang MY, Gow CH, Zhang JH, Hsu YL, et al. Positive end-expiratory pressure titration with electrical impedance tomography and pressure-volume curve in severe acute respiratory distress syndrome. Annals of Intensive Care. 2019; 9: 7.
[32] Becher T, Buchholz V, Hassel D, Meinel T, Schädler D, Frerichs I, et al. Individualization of PEEP and tidal volume in ARDS patients with electrical impedance tomography: a pilot feasibility study. Annals of Intensive Care. 2021; 11: 89.
[33] Bouhemad B, Brisson H, Le-Guen M. Bedside ultrasound assessment of positive end-expiratory pressure–induced lung recruitment. American Journal of Respiratory and Critical Care Medicine. 2011; 183: 341–347.
[34] Costamagna A, Pivetta E, Goffi A, Steinberg I, Arina P, Mazzeo AT, et al. Clinical performance of lung ultrasound in predicting ARDS morphology. Annals of Intensive Care. 2021; 11: 51.
[35] Singh A, Gupta A, Sen MK, Suri JC, Chakrabarti S, Bhattacharya D. Utility of bedside lung ultrasound for assessment of lung recruitment in a case of acute respiratory distress syndrome. Lung India. 2019; 36: 451.
[36] Ball L, Robba C, Maiello L, Herrmann J, Gerard SE, Xin Y, et al. Computed tomography assessment of PEEP-induced alveolar recruitment in patients with severe COVID-19 pneumonia. Critical Care. 2021; 25: 81.
[37] Chiumello D, Marino A, Brioni M, Menga F, Cigada I, Lazzerini M, et al. Visual anatomical lung CT scan assessment of lung recruitability. Intensive Care Medicine. 2013; 39: 66–73.
[38] Amato MBP, Barbas CSV, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. The New England Journal of Medicine. 1998; 338: 347–354.
[39] Amato MBP, Meade MO, Slutsky AS, Brochard L, Costa EL, Schoenfeld DA, et al. Driving pressure and survival in the acute respiratory distress syndrome. The New England Journal of Medicine. 2015; 372: 747–755.
[40] Guérin C, Papazian L, Reignier J, Ayzac L, Loundou A, Forel JM. Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials. Critical Care. 2016; 20: 384.
[41] Aoyama H, Pettenuzzo T, Aoyama K, Pinto R, Englesakis M, Fan E. Association of driving pressure with mortality among ventilated patients with acute respiratory distress syndrome. Critical Care Medicine. 2018; 46: 300–306.
[42] Costa ELV, Slutsky AS, Brochard LJ, Brower R, Serpa-Neto A, Cavalcanti AB, et al. Ventilatory variables and mechanical power in patients with acute respiratory distress syndrome. American Journal of Respiratory and Critical Care Medicine. 2021; 204: 303–311.
[43] Grieco DL, Chen L, Brochard L. Transpulmonary pressure: importance and limits. Annals of Translational Medicine. 2017; 5: 285–285.
[44] Talmor D, Sarge T, OʼDonnell CR, Ritz R, Malhotra A, Lisbon A, et al. Esophageal and transpulmonary pressures in acute respiratory failure. Critical Care Medicine. 2006; 34: 1389–1394.
[45] Talmor D, Sarge T, Malhotra A, O’Donnell CR, Ritz R, Lisbon A, et al. Mechanical ventilation guided by esophageal pressure in acute lung injury. The New England Journal of Medicine. 2008; 359: 2095–2104.
[46] Pelosi P, Goldner M, McKibben A, Adams A, Eccher G, Caironi P, et al. Recruitment and derecruitment during acute respiratory failure: an experimental study. American Journal of Respiratory and Critical Care Medicine. 2001; 164: 122–130.
[47] Beitler JR, Sarge T, Banner-Goodspeed VM, Gong MN, Cook D, Novack V, et al. Effect of titrating positive end-expiratory pressure (PEEP) with an esophageal pressure-guided strategy vs. an empirical high PEEP-Fio2 strategy on death and days free from mechanical ventilation among patients with acute respiratory distress syndrome: a randomized clinical trial. JAMA. 2019; 321: 846.
[48] Silva PL, Ball L, Rocco PRM, Pelosi P. Power to mechanical power to minimize ventilator-induced lung injury? Intensive Care Medicine Experimental. 2019; 7: 38.
[49] Becher T, van der Staay M, Schädler D, Frerichs I, Weiler N. Calculation of mechanical power for pressure-controlled ventilation. Intensive Care Medicine. 2019; 45: 1321–1323.
[50] Giosa L, Busana M, Pasticci I, Bonifazi M, Macrì MM, Romitti F, et al. Mechanical power at a glance: a simple surrogate for volume-controlled ventilation. Intensive Care Medicine Expermental. 2019; 7: 61.
[51] Marini JJ, Gattinoni L, Rocco PR. Estimating the damaging power of high-stress ventilation. Respiratory Care. 2020; 65: 1046–1052.
[52] Mahmoud O. Mechanical power is associated with increased mortality and worsened oxygenation in ARDS. Chest. 2020; 158: A679.
[53] Serpa Neto A, Deliberato RO, Johnson AEW, Bos LD, Amorim P, Pereira SM, et al. Mechanical power of ventilation is associated with mortality in critically ill patients: an analysis of patients in two observational cohorts. Intensive Care Medicine. 2018; 44: 1914–1922.
[54] Coppola S, Caccioppola A, Froio S, Formenti P, De Giorgis V, Galanti V, et al. Effect of mechanical power on intensive care mortality in ARDS patients. Critical Care. 2020; 24: 246.
[55] Downs JB, Stock MC. Airway pressure release ventilation: a new concept in ventilatory support. Critical Care Medicine. 1987; 15: 459–461.
[56] Jain SV, Kollisch-Singule M, Sadowitz B, Dombert L, Satalin J, Andrews P, et al. The 30-year evolution of airway pressure release ventilation (APRV). Intensive Care Medicine Experimental. 2016; 4: 11.
[57] Othman F, Alsagami N, Alharbi R, Almuammer Y, Alshahrani S, Ismaeil T. The efficacy of airway pressure release ventilation in acute respiratory distress syndrome adult patients: a meta-analysis of clinical trials. Annals of Thoracic Medicine. 2021; 16: 245.
[58] Chen C, Zhen J, Gong S, Yan J, Li L. Efficacy of airway pressure release ventilation for acute respiratory distress syndrome: a systematic review with meta-analysis. Annals of Palliative Medicine. 2021; 10: 10349–10359.
[59] Zhong X, Wu Q, Yang H, Dong W, Wang B, Zhang Z, et al. Airway pressure release ventilation versus low tidal volume ventilation for patients with acute respiratory distress syndrome/acute lung injury: a meta-analysis of randomized clinical trials. Annals of Translational Medicine. 2020; 8: 1641–1641.
[60] Sun X, Liu Y, Li N, You D, Zhao Y. The safety and efficacy of airway pressure release ventilation in acute respiratory distress syndrome patients : a PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2020; 99: e18586.
[61] Kollisch-Singule M, Andrews P, Satalin J, Gatto LA, Nieman GF, Habashi NM. The time-controlled adaptive ventilation protocol: mech-anistic approach to reducing ventilator-induced lung injury. European Respiratory Review. 2019; 28: 180126.
[62] Silva PL, Cruz FF, Samary CDS, Moraes L, de Magalhães RF, Fernandes MVS, et al. Biological response to time-controlled adaptive ventilation depends on acute respiratory distress syndrome etiology. Critical Care Medicine. 2018; 46: e609–e617.
[63] Daoud EG, Farag HL, Chatburn RL. Airway pressure release ventilation: what do we know? Respiratory Care. 2011; 57: 282–292.
[64] Downar J, Mehta S. Bench-to-bedside review: high-frequency oscillatory ventilation in adults with acute respiratory distress syndrome. Critical Care. 2006; 10: 240.
[65] Liu S, Yi Y, Wang M, Chen Q, Huang Y, Liu L, et al. Higher frequency ventilation attenuates lung injury during high-frequency oscillatory ventilation in sheep models of acute respiratory distress syndrome. Anesthesiology. 2013; 119: 398–411.
[66] Bollen CW, van Well GTJ, Sherry T, Beale RJ, Shah S, Findlay G, et al. High frequency oscillatory ventilation compared with conventional mechanical ventilation in adult respiratory distress syndrome: a randomized controlled trial [ISRCTN24242669]. Critical Care. 2005; 9: R430–R439.
[67] David M, Weiler N, Heinrichs W, Neumann M, Joost T, Markstaller K, et al. High-frequency oscillatory ventilation in adult acute respiratory distress syndrome. Intensive Care Medicine. 2003; 29: 1656–1665.
[68] Derdak S, Mehta S, Stewart TE, Sminth T, Rogers M, Buchman TG, et al. High-frequency oscillatory ventilation for acute respiratory distress syndrome in adults. American Journal of Respiratory Critical Care Medicine. 2002; 166: 801–808.
[69] Meade MO, Young D, Hanna S, Zhou Q, Bachman TE, Bollen C, et al. Severity of hypoxemia and effect of high-frequency oscillatory ventilation in acute respiratory distress syndrome. American Journal of Respiratory Critical Care Medicine. 2017; 196: 727–733.
[70] Sud S, Sud M, Friedrich JO, Wunsch H, Meade MO, Ferguson ND, et al. High-frequency ventilation versus conventional ventilation for treatment of acute lung injury and acute respiratory distress syndrome. Cochrane Database of Systematic Reviews. 2013; 28: CD004085.
[71] Myers M, Rodrigues N, Ari A. High-frequency oscillatory ventilation: a narrative review. Canadian Journal of Respiratory Therapy. 2019; 55: 40–46.
[72] Santana MCE, Garcia CSNB, Xisto DG, Nagato LK, Lassance RM, Prota LF, et al. Prone position prevents regional alveolar hyperinflation and mechanical stress and strain in mild experimental acute lung injury. Respiratory Physiology & Neurobiology. 2009; 167: 181–188.
[73] Taccone P, Pesenti A, Latini R, Polli F, Vagginelli F, Mietto C, et al. Prone positioning in patients with moderate and severe acute respiratory distress syndrome: a randomized controlled trial. JAMA. 2009; 302: 1977.
[74] Guérin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, et al. Prone positioning in severe acute respiratory distress syndrome. The New England Journal of Medicine. 2013; 368: 2159–2168.
[75] Moran JL, Graham PL. Multivariate meta-analysis of the mortality effect of prone positioning in the acute respiratory distress syndrome. Journal of Intensive Care Medicine. 2021; 36: 1323–1330.
[76] Munshi L, Del Sorbo L, Adhikari NKJ, Hodgson CL, Wunsch H, Meade MO, et al. Prone position for acute respiratory distress syndrome. A systematic review and meta-analysis. Annals of the American Thoracic Society. 2017; 14: S280–S288.
[77] Aoyama H, Uchida K, Aoyama K, Pechlivanoglou P, Englesakis M, Yamada Y, et al. Assessment of therapeutic interventions and lung protective ventilation in patients with moderate to severe acute respiratory distress syndrome: a systematic review and network meta-analysis. JAMA Network Open. 2019; 2: e198116.
[78] Sud S, Friedrich JO, Adhikari NKJ, Fan E, Ferguson ND, Guyatt G, et al. Comparative effectiveness of protective ventilation strategies for moderate and severe acute respiratory distress syndrome. A network meta-analysis. American Journal of Respiratory and Critical Care Medicine. 2021; 203: 1366–1377.
[79] Muscedere JG, Mullen JB, Gan K, Slutsky AS. Tidal ventilation at low airway pressures can augment lung injury. American Journal of Respiratory and Critical Care Medicine. 1994; 149: 1327–1334.
[80] Goligher EC, Hodgson CL, Adhikari NKJ, Meade MO, Wunsch H, Uleryk E, et al. Lung recruitment maneuvers for adult patients with acute respiratory distress syndrome. A systematic review and meta-analysis. Annals of the American Thoracic Society. 2017; 14: S304–S311.
[81] Rocco PR, Pelosi P, de Abreu MG. Pros and cons of recruitment maneuvers in acute lung injury and acute respiratory distress syndrome. Expert Review of Respiratory Medicine. 2010; 4: 479–489.
[82] Del Sorbo L, Tonetti T, Ranieri VM. Alveolar recruitment in acute respiratory distress syndrome: should we open the lung (no matter what) or may accept (part of) the lung closed? Intensive Care Medicine. 2019; 45: 1436–1439.
[83] Carvalho NC, Güldner A, Beda A, Rentzsch I, Uhlig C, Dittrich S, et al. Higher levels of spontaneous breathing reduce lung injury in experimental moderate acute respiratory distress syndrome. Critical Care Medicine. 2014; 42: e702–e715.
[84] Chanques G, Constantin JM, Devlin JW, Ely EW, Fraser GL, Gélinas C, et al. Analgesia and sedation in patients with ARDS. Intensive Care Medicine. 2020; 46: 2342–2356.
[85] Guérin C, Mancebo J. Prone positioning and neuromuscular blocking agents are part of standard care in severe ARDS patients: yes. Intensive Care Medicine. 2015; 41: 2195–2197.
[86] Papazian L, Forel JM, Gacouin A, Penot-Ragon C, Perrin G, Loundou A, et al. Neuromuscular blockers in early acute respiratory distress syndrome. The New England Journal of Medicine. 2010; 363: 1107–1116.
[87] Moss M, Huang DT, Brower RG, Ferguson ND, Ginde AA, Gong MN, et al. Early neuromuscular blockade in the acute respiratory distress syndrome. The New England Journal of Medicine. 2019; 380: 1997–2008.
[88] Ho ATN, Patolia S, Guervilly C. Neuromuscular blockade in acute respiratory distress syndrome: a systematic review and meta-analysis of randomized controlled trials. Journal of Intensive Care. 2020; 8: 12.
[89] Griffiths MJD, Evans TW. Inhaled nitric oxide therapy in adults. The New England Journal of Medicine. 2005; 353: 2683–2695.
[90] Gebistorf F, Karam O, Wetterslev J, Afshari A. Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) in children and adults. The Cochrane Database of Systematic Reviews. 2016; 6: CD002787.
[91] Alessandri F, Pugliese F, Ranieri VM. The role of rescue therapies in the treatment of severe ARDS. Respiratory Care. 2018; 63: 92–101.
[92] Abrams D, Schmidt M, Pham T, Beitler JR, Fan E, Goligher EC, et al. Mechanical ventilation for acute respiratory distress syndrome during extracorporeal life support. research and practice. American Journal of Respiratory and Critical Care Medicine. 2020; 201: 514–525.
[93] Murray JF, Matthay MA, Luce JM, Flick MR. An expanded definition of the adult respiratory distress syndrome. American Review of Respiratory Disease. 1988; 138: 720–723.
[94] Dechert RE, Park PK, Bartlett RH. Evaluation of the oxygenation index in adult respiratory failure. Journal of Trauma and Acute Care Surgery. 2014; 76: 469–473.
[95] Villar J, Ambrós A, Soler JA, Martínez D, Ferrando C, Solano R, et al. Age, PaO2/FIO2, and plateau pressure score: a proposal for a simple outcome score in patients with the acute respiratory distress syndrome. Critical Care Medicine. 2016; 44: 1361–1369.
[96] Zhu Y, Zhang M, Zhang R, Ye X, Wei J. Extracorporeal membrane oxy-genation versus mechanical ventilation alone in adults with severe acute respiratory distress syndrome: a systematic review and meta‐analysis. International Journal of Clinical Practice. 2021; 75: e14046.
[97] Graham PL, Moran JL. ECMO, ARDS and meta-analyses: bayes to the rescue? Journal of Critical Care. 2020; 59: 49–54.
[98] Wang J, Wang Y, Wang T, Xing X, Zhang G. Is extracorporeal membrane oxygenation the standard care for acute respiratory distress syndrome: a systematic review and meta-analysis. Hear, Lung & Circulation. 2021; 30: 631–641.
[99] Combes A, Peek GJ, Hajage D, Hardy P, Abrams D, Schmidt M, et al. ECMO for severe ARDS: systematic review and individual patient data meta-analysis. Intensive Care Medicine. 2020; 46: 2048–2057.
[100] Dao B, Savulescu J, Suen JY, Fraser JF, Wilkinson DJC. Ethical factors determining ECMO allocation during the COVID-19 pandemic. BMC Medical Ethics. 2021; 22: 70.
[101] Ball L, Barisione E, Mastracci L, Campora M, Costa D, Robba C, et al. Extension of collagen deposition in COVID-19 post mortem lung samples and computed tomography analysis findings. Internation Journal of Molecular Sciences. 2021; 22: 7498.
[102] Fajgenbaum DC, June CH. Cytokine storm. The New England Journal of Medicine. 2020; 383: 2255–2273.
[103] Li X, To KKW. Biomarkers for severe COVID-19. EBioMedicine. 2021; 68: 103405.
[104] Sinha P, Calfee CS. Phenotypes in acute respiratory distress syndrome: moving towards precision medicine. Current Opinion in Critical Care. 2019; 25: 12–20.
[105] Dakin J, Jones AT, Hansell DM, Hoffman EA, Evans TW. Changes in lung composition and regional perfusion and tissue distribution in patients with ARDS. Respirology. 2011; 16: 1265–1272.
[106] Robba C, Battaglini D, Ball L, Patroniti N, Loconte M, Brunetti I, et al. Distinct phenotypes require distinct respiratory management strategies in severe COVID-19. Respiratory Physiology & Neurobiology. 2020; 279: 103455.
[107] Chiumello D, Busana M, Coppola S, Romitti F, Formenti P, Bonifazi M, et al. Physiological and quantitative CT-scan characterization of COVID-19 and typical ARDS: a matched cohort study. Intensive Care Medicine. 2020; 46: 2187–2196.
[108] Ball L, Robba C, Herrmann J, Gerard SE, Xin Y, Mandelli M, et al. Lung distribution of gas and blood volume in critically ill COVID-19 patients: a quantitative dual-energy computed tomography study. Critical Care. 2021; 25: 214.
[109] Papoutsi E, Giannakoulis VG, Xourgia E, Routsi C, Kotanidou A, Siempos II. Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies. Critical Care. 2021; 25: 121.
[110] Perkins GD, Ji C, Connolly BA, Couper K, Lall R, Baillie JK, et al. Effect of noninvasive respiratory strategies on intubation or mortality among patients with acute hypoxemic respiratory failure and COVID-19: the RECOVERY-RS randomized clinical trial. Journal of the American Medical Association. 2022; 327: 546–558.
[111] Robba C, Battaglini D, Ball L, Pelosi P, Rocco PRM. Ten things you need to know about intensive care unit management of mechanically ventilated patients with COVID-19. Expert Review of Respiratory Medicine. 2021; 15: 1293–1302.
[112] Rossi S, Palumbo MM, Sverzellati N, Busana M, Malchiodi L, Bresciani P, et al. Mechanisms of oxygenation responses to proning and recruitment in COVID-19 pneumonia. Intensive Care Medicine. 2021; 48: 1–11.
[113] Langer T, Brioni M, Guzzardella A, Carlesso E, Cabrini L, Castelli G, et al. Prone position in intubated, mechanically ventilated patients with COVID-19: a multi-centric study of more than 1000 patients. Critical Care. 2021; 25: 128.
[114] Cunha M, Schardong J, Camponogara Righi N, Claudia Lunardi A , Nery de Sant’Anna G, Padrão Isensee L, et al. Impact of prone positioning on patients with COVID-19 and ARDS on invasive mechanical ventilation: a multicenter cohort study. Brazilian Journal of Pulmonology. 2022; 48: e20210374.
[115] Scaramuzzo G, Gamberini L, Tonetti T, Zani G, Ottaviani I, Mazzoli CA, et al. Sustained oxygenation improvement after first prone positioning is associated with liberation from mechanical ventilation and mortality in critically ill COVID-19 patients: a cohort study. Annals of Intensive Care. 2021; 11: 63.
[116] Park SY, Kim HJ, Yoo KH, Park YB, Kim SW, Lee SJ, et al. The efficacy and safety of prone positioning in adults patients with acute respiratory distress syndrome: a meta-analysis of randomized controlled trials. Journal of Thoracic Disease. 2015; 7: 356–367.
[117] Badulak J, Antonini MV, Stead CM, Shekerdemian L, Raman L, Paden ML, et al. Extracorporeal membrane oxygenation for COVID-19: updated 2021 guidelines from the extracorporeal life support organization. ASAIO Journal. 2021; 67: 485–495.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus: CiteScore 1.3 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.
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