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COVID-19-associated acute respiratory distress syndrome (CARDS): Current knowledge on pathophysiology and ICU treatment - A narrative review.
Pfortmueller, Carmen A; Spinetti, Thibaud; Urman, Richard D; Luedi, Markus M; Schefold, Joerg C.
  • Pfortmueller CA; Department of Intensive Care Medicine, Inselspital, Bern, University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland. Electronic address: carmen.pfortmueller@insel.ch.
  • Spinetti T; Department of Intensive Care Medicine, Inselspital, Bern, University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland. Electronic address: thibaud.spinetti@insel.ch.
  • Urman RD; Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA. Electronic address: rurman@bwh.harvard.edu.
  • Luedi MM; Department of Anaesthesiology and Pain Medicine, Inselspital, Bern, University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland. Electronic address: Markus.Luedi2@insel.ch.
  • Schefold JC; Department of Intensive Care Medicine, Inselspital, Bern, University Hospital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland. Electronic address: joerg.schefold@insel.ch.
Best Pract Res Clin Anaesthesiol ; 35(3): 351-368, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1049749
ABSTRACT
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces coronavirus-19 disease (COVID-19) and is a major health concern. Following two SARS-CoV-2 pandemic "waves," intensive care unit (ICU) specialists are treating a large number of COVID19-associated acute respiratory distress syndrome (ARDS) patients. From a pathophysiological perspective, prominent mechanisms of COVID19-associated ARDS (CARDS) include severe pulmonary infiltration/edema and inflammation leading to impaired alveolar homeostasis, alteration of pulmonary physiology resulting in pulmonary fibrosis, endothelial inflammation (endotheliitis), vascular thrombosis, and immune cell activation. Although the syndrome ARDS serves as an umbrella term, distinct, i.e., CARDS-specific pathomechanisms and comorbidities can be noted (e.g., virus-induced endotheliitis associated with thromboembolism) and some aspects of CARDS can be considered ARDS "atypical." Importantly, specific evidence-based medical interventions for CARDS (with the potential exception of corticosteroid use) are currently unavailable, limiting treatment efforts to mostly supportive ICU care. In this article, we will discuss the underlying pulmonary pathophysiology and the clinical management of CARDS. In addition, we will outline current and potential future treatment approaches.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Health Knowledge, Attitudes, Practice / Critical Care / COVID-19 / Intensive Care Units Type of study: Diagnostic study / Prognostic study / Reviews Limits: Humans Language: English Journal: Best Pract Res Clin Anaesthesiol Journal subject: Anesthesiology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Health Knowledge, Attitudes, Practice / Critical Care / COVID-19 / Intensive Care Units Type of study: Diagnostic study / Prognostic study / Reviews Limits: Humans Language: English Journal: Best Pract Res Clin Anaesthesiol Journal subject: Anesthesiology Year: 2021 Document Type: Article