Summary: <p>Lung protective ventilation for ARDS includes the use of low tidal volumes, positive-end expiratory pressure (PEEP), and limiting of airway plateau pressure to minimize ventilator-induced lung injury. However, in the sickest subset of patients with ARDS hypoxemia may persist despite optimal lung protective strategies. In this episode of Critical Matters, we discuss salvage therapies for patients with refractory hypoxemia. Our guest is Dr. Robert Hyzy, Medical Director of the Critical Care Medicine Unit and Co-Chair of the Critical Care Committee at the University of Michigan Hospital.</p> <h2>ADDITIONAL RESOURCES</h2> <ul> <li>The PROSEVA clinical trial showed that in patients with severe ARDS prone position ventilation improved mortality: <a href="https://bit.ly/2Dp3LdS" target="_blank" rel="noopener">https://bit.ly/2Dp3LdS</a> </li> <li>The ACURASYS clinical study showed that in patients with severe ARDS 48 hours of neuromuscular blockade was associated with improved mortality: <a href="https://bit.ly/2FqI7Zn" target="_blank" rel="noopener">https://bit.ly/2FqI7Zn</a> </li> <li>The EOLIA study was stooped early for futility. However, many think that it still has important findings regarding the use of ECMO in severe ARDS: <a href="https://bit.ly/2QI1Cxu">https://bit.ly/2QI1Cxu</a> </li> </ul> <h2>BOOKS MENTIONED IN THIS EPISODE</h2> <ul> <li> <em>Evidence-Based Critical Care: A Case Study Approach</em><em>: </em><a href="https://amzn.to/2PYeD8V">https://amzn.to/2PYeD8V</a> </li> </ul>
