Most ARDS patients improve their systemic oxygenation, as assessed by the ratio between arterial partial pressure of oxygen and inspired oxygen fraction, with conventional intensive care and the application of moderate-to-high levels of positive end-expiratory pressure. The acute respiratory distress syndrome (ARDS) is a severe form of acute hypoxemic respiratory failure caused by an insult to the alveolar-capillary membrane, resulting in a marked reduction of aerated alveoli, increased vascular permeability and subsequent interstitial and alveolar pulmonary edema, reduced lung compliance, increase of physiological dead space, and hypoxemia. 11Hedenstierna Laboratory, Department of Surgical Sciences, Anesthesiology and Critical Care, Uppsala University Hospital, Uppsala, Sweden.10Intensive Care Unit, Hospital Universitario La Princesa, Madrid, Spain.Negrín, Las Palmas de Gran Canaria, Spain 9Department of Thoracic Surgery, Hospital Universitario Dr.8Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, United States.7Harvard Medical School, Boston, MA, United States.6Department of Anesthesiology, Hospital Privado de Comunidad, Mar del Plata, Argentina.5Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain.
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