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Diagnostics
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What’s New in Acute Respiratory Distress Syndrome
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What’s New in Acute Respiratory Distress Syndrome

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 9917

Special Issue Editors

Dr. Michele Umbrello

E-Mail Website
Guest Editor
SC Rianimazione e Anestesia of ASST Ovest Milanese, Ospedale Nuovo di Legnano, Milano, Italy
Interests: respiratory physiology; lung imaging; diaphragm function; artificial nutrition and metabolism; muscle ultrasound
Special Issues, Collections and Topics in MDPI journals
Dr. Paolo Formenti

E-Mail Website
Guest Editor
Departement of Anesthesia and Intensive Care, ASST Nord Milano, Ospedale E Bassini, 20092 Cinisello Balsamo, Italy
Interests: respiratory care; respiratory physiology; ultrasound; lung imaging; pain medicine; anesthesiology; sepsi and new biomarkers; nutritional support in ICU; humanization of intensive care
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

More than 50 years after its first description, acute respiratory distress syndrome (ARDS) still represents one of the main causes of intensive care unit (ICU) admission and mortality. On top of that, the recent COVID-19 pandemic has caused an unprecedented surge of ICU admission of patients with ARDS, as well as an extensive increase in the number of research papers published on this topic.

Although the main treatment for ARDS remains symptomatic, several innovative therapies have been proposed based on recent preclinical trials. However, most of the promising candidate therapies have proven ineffective in human studies, possibly as a consequence of the clinical and biological heterogeneity of ARDS, and the inability of clinicians to identify and classify specific sub-phenotypes. This calls for the continuation of preclinical and clinical research on ARDS.

This Special Issue aims to outline the recent innovations in the field of ARDS to improve care and develop tailored and effective treatments for patients with ARDS, focused Original Research and Narrative or Systematic Reviews dealing with invasive or non-invasive ventilatory support, lung imaging or respiratory physiology are welcome.

Dr. Michele Umbrello
Dr. Paolo Formenti
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ARDS
  • lung protective ventilation
  • lung imaging
  • respiratory mechanics

Published Papers (4 papers)

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Review

16 pages, 1127 KiB  
Review
Advances in Biomarkers for Diagnosis and Treatment of ARDS
by Ruiqi Ge, Fengyun Wang and Zhiyong Peng
Diagnostics 2023, 13(21), 3296; https://doi.org/10.3390/diagnostics13213296 - 24 Oct 2023
Viewed by 1684
Abstract
Acute respiratory distress syndrome (ARDS) is a common and fatal disease, characterized by lung inflammation, edema, poor oxygenation, and the need for mechanical ventilation, or even extracorporeal membrane oxygenation if the patient is unresponsive to routine treatment. In this review, we aim to [...] Read more.
Acute respiratory distress syndrome (ARDS) is a common and fatal disease, characterized by lung inflammation, edema, poor oxygenation, and the need for mechanical ventilation, or even extracorporeal membrane oxygenation if the patient is unresponsive to routine treatment. In this review, we aim to explore advances in biomarkers for the diagnosis and treatment of ARDS. In viewing the distinct characteristics of each biomarker, we classified the biomarkers into the following six categories: inflammatory, alveolar epithelial injury, endothelial injury, coagulation/fibrinolysis, extracellular matrix turnover, and oxidative stress biomarkers. In addition, we discussed the potential role of machine learning in identifying and utilizing these biomarkers and reviewed its clinical application. Despite the tremendous progress in biomarker research, there remain nonnegligible gaps between biomarker discovery and clinical utility. The challenges and future directions in ARDS research concern investigators as well as clinicians, underscoring the essentiality of continued investigation to improve diagnosis and treatment. Full article
(This article belongs to the Special Issue What’s New in Acute Respiratory Distress Syndrome)
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18 pages, 710 KiB  
Review
Pulmonary Surfactant in Adult ARDS: Current Perspectives and Future Directions
by Ahilanandan Dushianthan, Michael P. W. Grocott, Ganapathy Senthil Murugan, Tom M. A. Wilkinson and Anthony D. Postle
Diagnostics 2023, 13(18), 2964; https://doi.org/10.3390/diagnostics13182964 - 15 Sep 2023
Cited by 4 | Viewed by 1554
Abstract
Acute respiratory distress syndrome (ARDS) is a major cause of hypoxemic respiratory failure in adults, leading to the requirement for mechanical ventilation and poorer outcomes. Dysregulated surfactant metabolism and function are characteristic of ARDS. A combination of alveolar epithelial damage leading to altered [...] Read more.
Acute respiratory distress syndrome (ARDS) is a major cause of hypoxemic respiratory failure in adults, leading to the requirement for mechanical ventilation and poorer outcomes. Dysregulated surfactant metabolism and function are characteristic of ARDS. A combination of alveolar epithelial damage leading to altered surfactant synthesis, secretion, and breakdown with increased functional inhibition from overt alveolar inflammation contributes to the clinical features of poor alveolar compliance and alveolar collapse. Quantitative and qualitative alterations in the bronchoalveolar lavage and tracheal aspirate surfactant composition contribute to ARDS pathogenesis. Compared to neonatal respiratory distress syndrome (nRDS), replacement studies of exogenous surfactants in adult ARDS suggest no survival benefit. However, these studies are limited by disease heterogeneity, variations in surfactant preparations, doses, and delivery methods. More importantly, the lack of mechanistic understanding of the exact reasons for dysregulated surfactant remains a significant issue. Moreover, studies suggest an extremely short half-life of replaced surfactant, implying increased catabolism. Refining surfactant preparations and delivery methods with additional co-interventions to counteract surfactant inhibition and degradation has the potential to enhance the biophysical characteristics of surfactant in vivo. Full article
(This article belongs to the Special Issue What’s New in Acute Respiratory Distress Syndrome)
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15 pages, 630 KiB  
Review
Acute Respiratory Distress Syndrome; A Review of Recent Updates and a Glance into the Future
by Husayn F. Ramji, Maida Hafiz, Hiba Hammad Altaq, Syed Talal Hussain and Fawad Chaudry
Diagnostics 2023, 13(9), 1528; https://doi.org/10.3390/diagnostics13091528 - 24 Apr 2023
Cited by 8 | Viewed by 3957
Abstract
Acute respiratory distress syndrome (ARDS) is a rapidly progressive form of respiratory failure that accounts for 10% of admissions to the ICU and is associated with approximately 40% mortality in severe cases. Despite significant mortality and healthcare burden, the mainstay of management remains [...] Read more.
Acute respiratory distress syndrome (ARDS) is a rapidly progressive form of respiratory failure that accounts for 10% of admissions to the ICU and is associated with approximately 40% mortality in severe cases. Despite significant mortality and healthcare burden, the mainstay of management remains supportive care. The recent pandemic of SARS-CoV-2 has re-ignited a worldwide interest in exploring the pathophysiology of ARDS, looking for innovative ideas to treat this disease. Recently, many trials have been published utilizing different pharmacotherapy targets; however, the long-term benefits of these agents remain unknown. Metabolomics profiling and stem cell transplantation offer strong enthusiasm and may completely change the outlook of ARDS management in the near future. Full article
(This article belongs to the Special Issue What’s New in Acute Respiratory Distress Syndrome)
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14 pages, 2008 KiB  
Review
Respiratory Variations of Central Venous Pressure as Indices of Pleural Pressure Swings: A Narrative Review
by Michele Umbrello, Sergio Cereghini and Stefano Muttini
Diagnostics 2023, 13(6), 1022; https://doi.org/10.3390/diagnostics13061022 - 7 Mar 2023
Cited by 2 | Viewed by 1827
Abstract
The measurement of pleural (or intrathoracic) pressure is a key element for a proper setting of mechanical ventilator assistance as both under- and over-assistance may cause detrimental effects on both the lungs and the diaphragm. Esophageal pressure (Pes) is the gold standard tool [...] Read more.
The measurement of pleural (or intrathoracic) pressure is a key element for a proper setting of mechanical ventilator assistance as both under- and over-assistance may cause detrimental effects on both the lungs and the diaphragm. Esophageal pressure (Pes) is the gold standard tool for such measurements; however, it is invasive and seldom used in daily practice, and easier, bedside-available tools that allow for rapid and continuous monitoring are greatly needed. The tidal swing of central venous pressure (CVP) has long been proposed as a surrogate for pleural pressure (Ppl); however, despite the wide availability of central venous catheters, this variable is very often overlooked in critically ill patients. In the present narrative review, the physiological basis for the use of CVP waveforms to estimate Ppl is presented; the findings of previous and recent papers that addressed this topic are systematically reviewed, and the studies are divided into those reporting positive findings (i.e., CVP was found to be a reliable estimate of Pes or Ppl) and those reporting negative findings. Both the strength and pitfalls of this approach are highlighted, and the current knowledge gaps and direction for future research are delineated. Full article
(This article belongs to the Special Issue What’s New in Acute Respiratory Distress Syndrome)
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