SOA 2015 debates on ARDS definition and treatment
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This document appears to be notes from a presentation on acute respiratory distress syndrome (ARDS) and acute lung injury (ALI). It discusses the history and definitions of ARDS/ALI, including the 1988 Murray Lung Injury Score and subsequent definitions from 1994, 2005, and 2012. It also summarizes initial successes in understanding the epidemiology and pathology, but then notes hundreds of failed clinical trials trying various treatments. It suggests reasons trials may have failed and ideas for improving future trials such as using tissue biomarkers and focusing on specific ARDS phenotypes. The presentation was given by Rob Mac Sweeney in London on December 8, 2015.
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SOA 2015 debates on ARDS definition and treatment
- 1. SOA 2015 Debates Rob Mac Sweeney @critcarereviews | www.bit.do/SOA15 London, December 8th 2015
- 6. Construction
- 12. René Laennec
- 15. Bilateral Infiltrates on CXR Acute Refractory Hypoxaemia
- 16. Absence of Heart Failure Bilateral Infiltrates on CXR Acute Refractory Hypoxaemia
- 17. Absence of Heart Failure Bilateral Infiltrates on CXR Loss of Compliance Acute Refractory Hypoxaemia
- 18. Partial Response to PEEP & Steroids Absence of Heart Failure Bilateral Infiltrates on CXR Loss of Compliance Acute Refractory Hypoxaemia
- 19. Absence of Heart Failure Bilateral Infiltrates on CXR Diffuse Alveolar Damage Loss of Compliance Acute Refractory Hypoxaemia Partial Response to PEEP & Steroids
- 20. Absence of Heart Failure Bilateral Infiltrates on CXR Diffuse Alveolar Damage Loss of Compliance Acute Refractory Hypoxaemia Partial Response to PEEP & Steroids
- 21. Absence of Heart Failure Bilateral Infiltrates on CXR Loss of Compliance Acute Refractory Hypoxaemia Partial Response to PEEP & Steroids
- 22. Absence of Heart Failure Bilateral Infiltrates on CXR Loss of Compliance Acute Refractory Hypoxaemia Partial Response to PEEP & Steroids Acute Onset Risk Factor
- 24. Murray Lung Injury Score American European Consensus Conference Definition 1988 1994
- 25. Murray Lung Injury Score American European Consensus Conference Definition Ferguson Definition 1988 1994 2005
- 26. Murray Lung Injury Score American European Consensus Conference Definition Ferguson Definition 1988 1994 2005 Berlin Definition 2012
- 28. Impact
- 29. 0 SCALE 2 4 6 10 m8 66.6 m Airbus A380-800 - 79.6 m 24.1mSpruceGoose Hughes H-4 Spruce GooseHughes H-4 Spruce Goose 84.0 m An-22518.1m An-225 Mriya 245.0 mLZ - 129 Hindenburg 73.0 m 24.1mA380-800 Airbus A380-800 76.4 m 19.6mB747-8I Boeing 747-8 Intercontinental 24.1mSpruceGoose 43.7mLZ-129Hindenburg
- 31. 0 SCALE 2 4 6 10 m8 66.6 m Airbus A380-800 - 79.6 m 24.1mSpruceGoose Hughes H-4 Spruce GooseHughes H-4 Spruce Goose 84.0 m An-22518.1m An-225 Mriya 245.0 mLZ - 129 Hindenburg 73.0 m 24.1mA380-800 Airbus A380-800 76.4 m 19.6mB747-8I Boeing 747-8 Intercontinental 24.1mSpruceGoose 43.7mLZ-129Hindenburg
- 42. Acute Lung Injury Acute Respiratory Distress Syndrome
- 43. Acute Lung Injury Acute Respiratory Distress Syndrome Mild Moderate Severe
- 44. Acute Lung Injury Acute Respiratory Distress Syndrome Mild Moderate Severe Pulmonary Extra-Pulmonary
- 45. Acute Lung Injury Acute Respiratory Distress Syndrome Mild Moderate Severe Pulmonary Extra-Pulmonary Inflammatory Non-Inflammatory
- 47. Crash & Burn
- 50. Deaths 44
- 51. Deaths 34
- 53. Deaths 52
- 54. Deaths 48
- 55. Deaths 73
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- 58. Patel. Chest 200429% Kao. Crit Care 200647% Charbonney. J Crit Care '0940% Guerin. Int Care Med 201458% Image Courtesy of Prof Claude Guerin Open Lung Biopsy
- 65. Hundreds of Negative Trials ? Steroids Surfactant APC Statins B2 Agonists Silvelestat Nitric Oxide Antioxidants …...et al
- 68. Helium
- 69. Helium Hydrogen
- 70. Tissue Biomarker
- 74. Hypoxaemia
- 76. Absence of Heart Failure
- 77. Left Atrial Hypertension Absence of Heart Failure PAOP < 18 mmHg
- 78. Acuity
- 79. ? Acuity
- 83. New Eras
- 85. The Reality
- 86. Post Airship Era
- 87. Post ARDS Era
- 89. SOA 2015 Debates Rob Mac Sweeney @critcarereviews | www.bit.do/SOA15 London, December 8th 2015