tailieunhanh - Báo cáo y học: " Acute lung injury outside the ICU: a significant proble"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Acute lung injury outside the ICU: a significant problem. | Available online http content 11 5 169 Commentary Acute lung injury outside the ICU a significant problem Simon J Finney and Timothy W Evans Department of Critical Care Imperial College School of Medicine Royal Brompton Hospital SW3 6NP London UK Corresponding author Timothy W Evans Published 26 October 2007 This article is online at http content 11 5 169 2007 BioMed Central Ltd Critical Care 2007 11 169 doi cc6128 See related research by Ferguson et al. http content 11 5 R96 Abstract The incidence of acute lung injury ALI is influenced by nature of the underlying clinical condition. The frequency with which ALI is likely to be encountered by those practicing outside the intensive care unit ICU setting is largely unknown. Data from the paper under discussion 1 indicates that ALI is seen relatively frequently in general wards and can be managed there until death or recovery. In patients with predisposing illnesses directly involving the lung progression to ALI can be rapid. Acute lung injury ALI and its extreme manifestation the acute respiratory distress syndrome ARDS complicate a wide variety of serious medical and surgical conditions not all of which affect the lung directly 2 . ALI and ARDS are defined by varying degrees of refractory hypoxemia seen in association with bilateral lung infiltrates on chest radiography in the absence of left atrial hypertension thereby excluding hydrostatic pulmonary oedema as a cause but in the presence of a clinical condition known to precipitate the syndrome. Patients can present with either ALI or full-blown ARDS which may have prognostic significance. Some 35 of patients with ALI seem to develop ARDS within three days of intensive care unit ICU admission 3 . Early estimates of the incidence of ARDS varied from to 75 cases per 100 000 population - the considerable variation being attributable in part to the lack of accepted and widely applied defining criteria.