El síndrome de dificultad respiratoria aguda (SDRA) es una causa grave de insuficiencia respiratoria aguda, caracterizada por infiltración pulmonar bilateral y un conjunto definido de criterios clínicos y fisiológicos. Esta página describe el enfoque de manejo de primera línea para esta presentación.
DOI: 10.1186/s40560-023-00658-3
Among ARF, acute respiratory distress syndrome (ARDS) is a serious condition associated with bilateral lung infiltration.
The clinical diagnosis of ARDS is currently based on the Berlin definition: (1) PaO2/FIO2 ratio <= 300 under positive end-expiratory pressure (PEEP)/continuous positive airway pressure (CPAP) >= 5 cmH2O; (2) acute onset within a week; (3) bilateral shadows in the lung fields, and (4) respiratory failure that cannot be explained by cardiac failure or excess fluid alone.
Regarding ARDS, IPPV has been the gold standard; however, HFNC and NPPV are weakly recommended as alternative options to initial management in JRS/JSICM/JSRCM-GL2021.
Based on this evidence, the JRS/JSICM/JSRCM-GL2021 and FICM/ICS-GL 2018 weakly recommend restrictive fluid management.
Patients in the dexamethasone group were treated with 20 mg intravenous dexamethasone (methylprednisolone equivalent 100-120 mg) daily for five days and 10 mg for additional five days.
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