ReviewCritical care (London, England)2023
Management of severe acute respiratory distress syndrome: a primer.
Review in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 2 syntheses or guidelines pooled it, 102 citations in OpenAlex.
- Driving pressure-limited ventilation strategies versus conventional lung protective ventilation strategies for patients with ARDS/ARF: a systematic review and meta-analysis of randomized controlled trials.Critical care (London, England) · 2025Pooled it
- Lung ultrasound score and in-hospital mortality of adults with acute respiratory distress syndrome: a meta-analysis.BMC pulmonary medicine · 2024Pooled it
- Safety, tolerability, pharmacokinetics, pharmacodynamics, and immunogenicity of STSA-1002, recombinant anti-human C5a fully human monoclonal antibody, in a randomized, first-in-human phase I study in healthy adults.Frontiers in pharmacology · 2026Trial
- The impact of PEEP-guided electrical impedance tomography on oxygenation and respiratory mechanics in moderate-to-severe ARDS: a randomized controlled trial.Scientific reports · 2025Trial
- A Review of the Role of Artificial Intelligence in Patients on Extracorporeal Membrane Oxygenation: A Scoping Review Study.Health science reports · 2026Review
- Mechanical stress promotes excessive NETs and exacerbates acute lung injury via Piezo1-mediated mitochondrial dysfunction.Redox biology · 2026Article
- Association between steroid therapy and increased mortality in patients at risk for ARDS.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Article
- Mechanical ventilation activates PERK/eIF2α and NOD1 pathways that contribute to NF-κB-driven inflammation in VILI.Respiratory research · 2026Article
- Vertical Displacement Index and Early Treatment-Related Physiological Improvement in Acute Respiratory Failure: An Exploratory Ultrasound-Based Study.Advances in respiratory medicine · 2026Observational
- Sedation as an Immunomodulator of Inflammatory Responses in the Lung-Brain Axis of ARDS.International journal of molecular sciences · 2026Review
- Setting PEEP in patients with COVID-19-related ARDS: a physiological comparison between methods.Intensive care medicine experimental · 2026Article
- Treatment Response Phenotyping Informed by Patient Physiologic Characteristics Could Drive Precision Critical Care Through Augmented Intelligence: A Narrative Review.CHEST critical care · 2026Article
- Pulmonary Vascular Endothelial Cells in Lung Diseases: Mechanisms, Therapeutic Strategies, and Future Directions.Cell proliferation · 2026Review
- A Comparative Study of Glucocorticoids Efficacy in Acute Respiratory Distress Syndrome.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Lipoxin A4 AttenuatesJournal of inflammation research · 2026Article
- The alveolar edema equation.Frontiers in physiology · 2026Article
- Advances in mechanical ventilation for critically ill patients: strategies for respiratory support and complication management.American journal of translational research · 2026Review
- Effect of enteral nutrition support combined with prone position mechanical ventilation on respiratory function, nutritional status, and inflammatory response in patients with severe pneumonia.Frontiers in physiology · 2026Article
- Nursing interventions and multidomain physiological trajectories in ARDS: a retrospective cohort study.Frontiers in medicine · 2026Article
- A gradient boosting machine model for predicting prognosis in patients with acute respiratory distress syndrome.American journal of translational research · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
This narrative review explores the physiology and evidence-based management of patients with severe acute respiratory distress syndrome (ARDS) and refractory hypoxemia, with a focus on mechanical ventilation, adjunctive therapies, and veno-venous extracorporeal membrane oxygenation (V-V ECMO). Severe ARDS cases increased dramatically worldwide during the Covid-19 pandemic and carry a high mortality. The mainstay of treatment to improve survival and ventilator-free days is proning, conservative fluid management, and lung protective ventilation. Ventilator settings should be individualized when possible to improve patient-ventilator synchrony and reduce ventilator-induced lung injury (VILI). Positive end-expiratory pressure can be individualized by titrating to best respiratory system compliance, or by using advanced methods, such as electrical impedance tomography or esophageal manometry. Adjustments to mitigate high driving pressure and mechanical power, two possible drivers of VILI, may be further beneficial. In patients with refractory hypoxemia, salvage modes of ventilation such as high frequency oscillatory ventilation and airway pressure release ventilation are additional options that may be appropriate in select patients. Adjunctive therapies also may be applied judiciously, such as recruitment maneuvers, inhaled pulmonary vasodilators, neuromuscular blockers, or glucocorticoids, and may improve oxygenation, but do not clearly reduce mortality. In select, refractory cases, the addition of V-V ECMO improves gas exchange and modestly improves survival by allowing for lung rest. In addition to VILI, patients with severe ARDS are at risk for complications including acute cor pulmonale, physical debility, and neurocognitive deficits. Even among the most severe cases, ARDS is a heterogeneous disease, and future studies are needed to identify ARDS subgroups to individualize therapies and advance care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.