Precision Medicine for Acute Respiratory Distress Syndrome (ARDS)

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: closed (10 July 2023) | Viewed by 10473

Special Issue Editor

1. Department of Anesthesiology and Intensive Care Medicine, University Hospital of Ostrava, Ostrava-Poruba, Czech Republic
2. Institute of Physiology and Pathophysiology, Department of Intensive Care Medicine and Forensic Studies, Faculty Of Medicine, University Of Ostrava, Ostrava, Czech Republic
3. Department of Intensive Medicine, Emergency Medicine and Forensic Studies, Faculty Of Medicine, University of Ostrava, Ostrava, Czech Republic
Interests: acute respiratory failure; ARDS; pathophysiology; mechanical ventilation; ECMO; ventilator-induced lung injury

Special Issue Information

Dear Colleagues,

Acute respiratory distress syndrome (ARDS) is the most severe form of respiratory failure, significantly affecting the morbidity and mortality of critical care patients. ARDS is caused by various lung-injuring factors, leading to seemingly similar clinical manifestations requiring uniform management. However, the disease course and outcomes usually significantly differ in terms of the type of injury, intensity, and time of action of the factor. Differences can also be found between patients suffering from the same injury. An example is high (H) versus low (L) phenotype COVID-19-related ARDS, as described by Gattinoni. Phenotypic divisions of ARDS related to extrapulmonary and pulmonary causes can be considered some of the most clinically relevant. ARDS is based on two principal pathways leading to lung injury and, among other issues, encompasses different responses to therapeutic interventions. Phenotypes of ARDS are nowadays one of the leading ARDS-related topics; recently, even revoking the term ARDS was proposed.

In this Special Issue, we welcome authors to submit papers concerning various injury-specific types of ARDS, focusing on pathophysiologic and phenotypic differences and the relationship with possible future changes in diagnostic and treatment approaches.

Dr. Jan Máca
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • acute respiratory distress syndrome
  • mechanical ventilation
  • ventilator-induced lung injury
  • critical care
  • extracorporeal membrane oxygenation
  • phenotypes

Published Papers (3 papers)

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Review

14 pages, 1495 KiB  
Review
Patient Self-Inflicted Lung Injury—A Narrative Review of Pathophysiology, Early Recognition, and Management Options
by Peter Sklienka, Michal Frelich and Filip Burša
J. Pers. Med. 2023, 13(4), 593; https://doi.org/10.3390/jpm13040593 - 28 Mar 2023
Cited by 5 | Viewed by 5093
Abstract
Patient self-inflicted lung injury (P-SILI) is a life-threatening condition arising from excessive respiratory effort and work of breathing in patients with lung injury. The pathophysiology of P-SILI involves factors related to the underlying lung pathology and vigorous respiratory effort. P-SILI might develop both [...] Read more.
Patient self-inflicted lung injury (P-SILI) is a life-threatening condition arising from excessive respiratory effort and work of breathing in patients with lung injury. The pathophysiology of P-SILI involves factors related to the underlying lung pathology and vigorous respiratory effort. P-SILI might develop both during spontaneous breathing and mechanical ventilation with preserved spontaneous respiratory activity. In spontaneously breathing patients, clinical signs of increased work of breathing and scales developed for early detection of potentially harmful effort might help clinicians prevent unnecessary intubation, while, on the contrary, identifying patients who would benefit from early intubation. In mechanically ventilated patients, several simple non-invasive methods for assessing the inspiratory effort exerted by the respiratory muscles were correlated with respiratory muscle pressure. In patients with signs of injurious respiratory effort, therapy aimed to minimize this problem has been demonstrated to prevent aggravation of lung injury and, therefore, improve the outcome of such patients. In this narrative review, we accumulated the current information on pathophysiology and early detection of vigorous respiratory effort. In addition, we proposed a simple algorithm for prevention and treatment of P-SILI that is easily applicable in clinical practice. Full article
(This article belongs to the Special Issue Precision Medicine for Acute Respiratory Distress Syndrome (ARDS))
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12 pages, 1097 KiB  
Review
Individualizing Fluid Management in Patients with Acute Respiratory Distress Syndrome and with Reduced Lung Tissue Due to Surgery—A Narrative Review
by Jan Benes, Jiri Kasperek, Olga Smekalova, Vaclav Tegl, Jakub Kletecka and Jan Zatloukal
J. Pers. Med. 2023, 13(3), 486; https://doi.org/10.3390/jpm13030486 - 08 Mar 2023
Viewed by 3133
Abstract
Fluids are the cornerstone of therapy in all critically ill patients. During the last decades, we have made many steps to get fluid therapy personalized and based on individual needs. In patients with lung involvement—acute respiratory distress syndrome—finding the right amount of fluids [...] Read more.
Fluids are the cornerstone of therapy in all critically ill patients. During the last decades, we have made many steps to get fluid therapy personalized and based on individual needs. In patients with lung involvement—acute respiratory distress syndrome—finding the right amount of fluids after lung surgery may be extremely important because lung tissue is one of the most vulnerable to fluid accumulation. In the current narrative review, we focus on the actual perspectives of fluid therapy with the aim of showing the possibilities to tailor the treatment to a patient’s individual needs using fluid responsiveness parameters and other therapeutic modalities. Full article
(This article belongs to the Special Issue Precision Medicine for Acute Respiratory Distress Syndrome (ARDS))
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10 pages, 636 KiB  
Review
Practical Aspects of Esophageal Pressure Monitoring in Patients with Acute Respiratory Distress Syndrome
by Pavel Dostal and Vlasta Dostalova
J. Pers. Med. 2023, 13(1), 136; https://doi.org/10.3390/jpm13010136 - 10 Jan 2023
Cited by 1 | Viewed by 1797
Abstract
Esophageal pressure (Pes) monitoring is a minimally invasive advanced respiratory monitoring method with the potential to guide ventilation support management. Pes monitoring enables the separation of lung and chest wall mechanics and estimation of transpulmonary pressure, which is recognized as [...] Read more.
Esophageal pressure (Pes) monitoring is a minimally invasive advanced respiratory monitoring method with the potential to guide ventilation support management. Pes monitoring enables the separation of lung and chest wall mechanics and estimation of transpulmonary pressure, which is recognized as an important risk factor for lung injury during both spontaneous breathing and mechanical ventilation. Appropriate balloon positioning, calibration, and measurement techniques are important to avoid inaccurate results. Both the approach of using absolute expiratory Pes values and the approach based on tidal Pes difference have shown promising results for ventilation adjustments, with the potential to decrease the risk of ventilator-induced lung injury. Full article
(This article belongs to the Special Issue Precision Medicine for Acute Respiratory Distress Syndrome (ARDS))
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