Acute Respiratory Distress Syndrome (ARDS): deep resolution and response strategy

Acute Respiratory Distress Syndrome (ARDS): The Acute Respiratory Distress Syndrome (ARDS) is an acute pneumonia disease caused by a variety of causes, characterized by rapid respiratory failure and persistent hypoxiaemia. As ARDS is moving rapidly and has a high rate of death, timely identification and effective treatment are essential. This paper will explore in depth the definition of ARDS, its causes, clinical performance, diagnosis, prevention and treatment strategies, and will use relevant literature to support the discussion.The definition and cause of ARDS was first described by Ashbaugh in 1967 and its definition, diagnostic criteria have evolved and developed as the understanding of the ARDS pathology has been growing. The new global definition of ARDS, published in 2023, has undergone significant changes, including the inclusion of SpO2/FiO2 as the ARDS diagnostic standard, the addition of new parameters for high-flow humid oxygen therapy as the basis for the ARDS diagnosis for patients without intubation, and the increased value of ultrasound diagnostics. ARDS has a very wide range of causes, including both internal and external. Intra-pulmonary factors such as pneumonia, lung contusions, drowning, etc. The external factors include acute whole-body infections, severe multiple shock, high-risk surgery (e.g. heart surgery, artery surgery, etc.), high-volume blood transfusions, drug poisoning, pancreasitis and post-cardial pulmonary transfer.ii. The ARDS clinical performance ARDS is very acute, with the main clinical manifestations being respiratory difficulties, lip and toe prolapse, and respiratory distress (extreme oxygen deficiency) that cannot be mitigated by routine oxygen therapy. Patients can be accompanied by symptoms such as chest suffocation, coughing and haematosis, and people in critical condition can experience cognitive disorders and even die. Medical examinations reveal signs such as fast breathing, nose fanning and trident. There was no sound at the early stage of the hearing of the double lungs, anecdotals and acoustics, at a later stage of smell and wet, and visible on the back of the bed. These symptoms are closely related to the patient ‘ s prognosis. ARDS patients often require mechanical air support because of severe hypoxiaemia, which has a significant impact on their quality of life and prognosis.The ARDS diagnosis is based on clinical performance, video-testing, arterial blood and gas analysis and risk factors. According to the “Berlin definition”, the ARDS diagnosis is subject to three criteria: (1) the onset of the disease: within one week of the known clinical cause or an increase in the new/pre-respiratory symptoms; (2) the chest image: a chest plate or CT scan can see a double-side shadow and cannot be fully explained by plethoral fluids, lung leaves/pulmonary atrophy, knots;3) Pulmonary edema: the cause of respiratory failure cannot be explained by heart failure or increased water load. In addition, an arterial blood and gas analysis shows a decrease in the arterial oxygen spectro-pressure, i.e., arterial low oxygen haemorrhage, which is an important basis for the diagnosis of ARDS.IV. ARDS prevention strategies can be divided into primary, secondary and tertiary prevention. The first level of prevention is aimed at avoiding the development of disease and is aimed at patients who have or will have ARDS risk factors before any sign of respiratory insufficiency occurs. Secondary prevention aims to detect, treat pre-clinical state to reduce severity, reduce or eliminate after-effects, requiring early screening and intervention. The three levels of prevention are aimed at mitigating the impact of existing diseases, improving the quality of survival of patients and requiring accurate diagnosis and follow-up.The ARDS treatment strategy has evolved from a simple “pulmonary protection” to “pulmonary, right heart and muscular protection”. The protective pulmonary ventilation strategy is the foundation of ARDS treatment, with a target tide of 4-6 ml/kg PBW and a platform pressure of < 30 cm H2O. Subergular aerobics and oxidation of the body exterior (ECMO) are important tools for the treatment of medium-heavy ARDS, which can improve oxygen combinations and reduce disease and death rates.VI. The progress and future direction of ARDS has been further developed, with the discovery of the pathological mechanisms of ARDS and new treatment methods and diagnostic techniques. Future research should be based on the concept of precision medicine, in-depth exploration of the characterization of ARDS, understanding of its pathological physiological mechanisms and the development of new bedside diagnostics, monitoring techniques and therapeutic drugs. Through early identification, timely intervention and multidisciplinary cooperation, we can better manage the ARDS disease and reduce its impact on human health.Reference 1. [Scientific Chinese] scientific encyclopedia preparation and application project. Acute respiratory distress syndrome [EB/OL].2. What are the causes of the ARDS? [EB/OL] Doctor Come, 2023-05-05.Roshonping. Acute Respiratory Distress Syndrome (ARDS): Understanding and Response [EB/OL]. Emergency intensive care ward, 2023-03-15.4. Progress in treatment for acute respiratory distress syndrome [J]. Chinese Journal of Tuberculosis and Respiration, 2022, 45 (10): 943-948.5. Progress in research on the ARDS prevention strategy [J]. Chinese emergency medicine, 2021, 41(6): 496-500.The purpose of this paper is to provide readers with general knowledge of acute respiratory distress syndrome (ARDS) and to help them better understand and respond to the disease. We can better protect our health and that of our families by better understanding the definition of ARDS, its causes, clinical performance, diagnosis, prevention and treatment strategies.