Pharmacologic Treatments in Acute Respiratory Failure

Elizabeth Levy; John P Reilly

doi:10.1016/j.ccc.2023.12.002

Pharmacologic Treatments in Acute Respiratory Failure

Crit Care Clin. 2024 Apr;40(2):275-289. doi: 10.1016/j.ccc.2023.12.002. Epub 2023 Dec 29.

Authors

Elizabeth Levy¹, John P Reilly²

Affiliations

¹ Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, PA 19146, USA.
² Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pennsylvania, Perelman School of Medicine, 3400 Spruce Street, Philadelphia, PA 19146, USA. Electronic address: John.Reilly@pennmedicine.upenn.edu.

PMID: 38432696
DOI: 10.1016/j.ccc.2023.12.002

Abstract

Acute respiratory failure relies on supportive care using non-invasive and invasive oxygen and ventilatory support. Pharmacologic therapies for the most severe form of respiratory failure, acute respiratory distress syndrome (ARDS), are limited. This review focuses on the most promising therapies for ARDS, targeting different mechanisms that contribute to dysregulated inflammation and resultant hypoxemia. Significant heterogeneity exists within the ARDS population. Treatment requires prompt recognition of ARDS and an understanding of which patients may benefit most from specific pharmacologic interventions. The key to finding effective pharmacotherapies for ARDS may rely on deeper understanding of pathophysiology and bedside identification of ARDS subphenotypes.

Keywords: Acute respiratory distress syndrome; Acute respiratory failure; COVID-19; Corticosteroids; Neuromuscular blockade; Pharmacotherapy.

Publication types

Review

MeSH terms

Humans
Inflammation
Oxygen
Respiratory Distress Syndrome* / drug therapy

Substances

Oxygen