Acute Respiratory Distress Syndrome: Advances in Diagnostic Tools and Disease Management

Preface
Contents
Part I: Definition, Epidemiology, and Pathophysiology
	Chapter 1: Definition of ARDS: Does the Berlin Definition Fit the Clinical Entity and Predict the Outcome?
		1 Introduction
		2 Before 1967
		3 1967–1992
			3.1 First Report of ARDS by Ashbaugh and Colleagues
			3.2 Murray’s Definition with Lung Injury Score
		4 1992–2012
			4.1 AECC Definition
			4.2 Limitation of AECC Definition
			4.3 DELPHI Definition
		5 After 2012
			5.1 Berlin Definition; Draft Definition
			5.2 Berlin Definition; Empirical Evaluation of the Draft Definition
			5.3 Berlin Definition; Limitation of the Berlin Definition
			5.4 Future Perspective
		6 Conclusion
		References
	Chapter 2: Epidemiology and Risk Factors of ARDS: How Many Is the Real Incidence of ARDS?
		1 Introduction
		2 Epidemiology
			2.1 Incidence of ARDS
			2.2 Clinical Risk Factors
			2.3 Comorbidities and Susceptibility to ARDS
			2.4 Hospital-Based Modifiable Exposures and ARDS
			2.5 Interaction of Factors as Risk Enhancement
		3 Mortality of ARDS
			3.1 Mortality Related to Severity of ARDS
			3.2 Mortality Related to the Cause of Lung Injury
			3.3 Ventilatory Strategy and Mortality
			3.4 Trends in Mortality
			3.5 Mortality Related to Organizational Factors
			3.6 Mortality Related to Unmodifiable Factors
			3.7 Genetic Factors and ARDS
			3.8 Outcomes Other than Mortality
			3.9 Quality of Life After ARDS
		4 Conclusions
		References
	Chapter 3: Pathophysiology of ARDS: What Is the Current Understanding of Pathophysiology of ARDS?
		1 Introduction
		2 Genetic Factors
		3 Innate Immunity
		4 Cellular and Molecular Pathogenesis
			4.1 Accumulation of Neutrophils in the Lungs
			4.2 Neutrophil-Derived Substances
				4.2.1 Reactive Oxygen Species
				4.2.2 Proteolytic Enzymes
				4.2.3 Neutrophil Extracellular Traps
			4.3 Impairment of Endothelial and Epithelial Barrier Functions
		5 Development of Permeability Edema
		6 Changes in the Pulmonary Circulation During ARDS
			6.1 Hypoxic Pulmonary Vasoconstriction
			6.2 Increased Pulmonary Vascular Tone
			6.3 Coagulation Abnormality
		7 Pathophysiology
			7.1 Intrapulmonary Shunt
			7.2 Changes in Ventilation Mechanics
				7.2.1 Decreased Lung Compliance (Hardening of the Lungs)
				7.2.2 Increased Respiratory Resistance
			7.3 Impaired Diffusing Capacity
			7.4 Ventilation-Perfusion Mismatch
			7.5 Elevated Pulmonary Vascular Resistance
			7.6 Pulmonary Surfactant Dysfunction
				7.6.1 Pulmonary Surfactant Dysfunction During ARDS
				7.6.2 Influence of Respiratory Management on Pulmonary Surfactant
		8 Assessment of Respiratory Function of ARDS Patients
			8.1 Practical Assessment of Respiratory Function
			8.2 Exhaled Gas Analysis
			8.3 Evaluation of Lung Volume and Regional Lung Function by Chest CT
		9 Conclusion
		References
Part II: Diagnosis
	Chapter 4: Imaging Diagnosis of ARDS: How Can We Know the Severity and Prognosis from the Lung Imaging?
		1 Introduction
		2 Chest Radiograph
		3 Chest HRCT
		4 Conclusion
		References
	Chapter 5: Serum Markers of ARDS: How Can We Know the Severity and Prognosis from the Serum Markers?
		1 Introduction
		2 Serum Biomarkers Associated with Prognosis in ARDS
			2.1 Biomarkers Associated with Coagulation and Fibrinolysis
			2.2 Biomarkers Associated with the Inflammatory Cascade
			2.3 Biomarkers Associated with Endothelium Damage
			2.4 Biomarkers Associated with Epithelium Damage
		3 What Is the Useful Biomarker for Coronavirus Disease 2019 (COVID-19)-Related ARDS?
		4 Conclusion
		References
Part III: Management
	Chapter 6: Ventilatory Management for Patients with ARDS: Established and Rapidly Evolving Strategies
		1 Introduction
		2 Ventilator-Induced Lung Injury
		3 “Classical,” or Established, Recommendations in Ventilatory Settings
			3.1 Limiting Tidal Volume on the Basis of Predicted Body Weight and Plateau Airway Pressure
			3.2 Selecting Positive End-Expiratory Pressure from Positive End-Expiratory Pressure/FiO2 Tables
			3.3 Prone Positioning
		4 Emerging Strategies in Lung Protection and Underlying Pathophysiology
			4.1 Using Driving Pressure (ΔP) to Identify an Individualized Acceptable Tidal Volume
			4.2 Transpulmonary Pressure and Esophageal Pressure Monitoring
			4.3 Patient Self-Inflicted Lung Injury and Controlling Patients’ Inspiratory Effort
		5 Considerations for Managing ARDS Patients with COVID-19
			5.1 Poor Correlation Between Hypoxia Severity and Reduction in FRC
			5.2 Persistent Strong Inspiratory Effort and High Incidence of Re-intubation
		6 Conclusions
		References
	Chapter 7: Noninvasive Ventilation and High-Flow Oxygen Therapy for ARDS: Does Noninvasive Ventilatory Management Improve the Outcome of ARDS Patients?
		1 Introduction
		2 Noninvasive Ventilation
			2.1 Background
			2.2 Mechanism
			2.3 Evidence
				2.3.1 Comparison with Intubation and Mechanical Ventilation
				2.3.2 Comparison with Oxygen Therapy
			2.4 Actual Setting Method of NIV
				2.4.1 Indications for NIV
				2.4.2 Initial Settings and Method of Introduction of NIV
				2.4.3 Types of NIV
			2.5 New Era of NIV in ARDS
		3 High-Flow Nasal Cannula Oxygen Therapy
			3.1 Background
			3.2 Mechanism
				3.2.1 Maintenance of Airway Mucociliary Clearance
				3.2.2 Effect of Washing Out Anatomical Dead Space
				3.2.3 Accurate Setting of Inspiratory Oxygen Fraction at High Concentrations
				3.2.4 PEEP-Like Effect and Alveolar Recruitment
			3.3 Evidence
			3.4 Actual Setting Method of HFNC
				3.4.1 Indications for HFNC
				3.4.2 Initial HFNC Settings and Method of Introduction
		4 Conclusion
		References
	Chapter 8: Fluid and Nutritional Management of ARDS: What Is the Ideal Fluid and Nutritional Management for an ARDS Patient?
		1 Introduction
		2 Fluid Balance
			2.1 Animal Studies
			2.2 Current Evidences
			2.3 Significant Considerations for Conservative Fluid Management
			2.4 Recent Advances
			2.5 Combined Use of Diuretics and Albumin
		3 Nutrition
			3.1 Current Guidelines
			3.2 Target Energy
			3.3 Management of Blood Glucose Level
			3.4 Avoiding Refeeding Syndrome
			3.5 Current Evidences for Omega-3 Fatty Acids
			3.6 Possible Benefit of Other Nutrients
			3.7 Nutritional Management for COVID-19
		4 Conclusion
		References
	Chapter 9: CHDF and ECMO for ARDS: Does CHDF and ECMO Improve the Outcome of ARDS Patients?
		1 CHDF
		2 ECMO
			2.1 Establishment of ECMO for Respiratory Failure
			2.2 Indications of ECMO for Adult Respiratory Failure
			2.3 Practice of ECMO Management for Respiratory Failure
		References
	Chapter 10: Physiotherapy and Early Rehabilitation for Patients with ARDS: Does Physiotherapy Improve the Functional Outcome of ARDS Patients?
		1 Introduction
		2 Functional Disabilities in ARDS Survivors
			2.1 Physical, Functional, and Health-Related Quality of Life Impairments
			2.2 Detrimental Effects of Bed Rest
			2.3 ICU-Acquired Weakness
			2.4 ICU-Acquired Delirium
			2.5 Post Intensive Care Syndrome in ARDS Patients
		3 Physiotherapy Program
			3.1 Aim
			3.2 Components of a Physiotherapy Program
				3.2.1 Respiratory Physiotherapy
					3.2.1.1 Body Positioning
					3.2.1.2 Airway Clearance Techniques
					3.2.1.3 Inspiratory Muscle Training
				3.2.2 Early Mobilization
					3.2.2.1 Passive Mobilization
					3.2.2.2 Active Exercise and Progressive Mobilization
		4 Physiotherapy Practice for Patients with ARDS
			4.1 Acute Phase
			4.2 Earlier Stages in Stable Phase
			4.3 Stable Phase
			4.4 Recovery Phase During ICU Stay
			4.5 Recovery Phase After ICU Discharge
		5 Evidence on Physiotherapy in Patients With ARDS
		6 Conclusion
		References
Part IV: Current Topics
	Chapter 11: MicroRNAs and Extracellular Vesicles for Diagnosis of ARDS: Can MicroRNAs and Extracellular Vesicles Be Helpful for Early Diagnosis or Risk Evaluation of ARDS?
		1 Introduction
		2 MicroRNAs in ARDS
		3 Extracellular Vesicles in ARDS
		4 Conclusion
		References
	Chapter 12: Stem Cell Therapy and Regenerative Medicine for ARDS: Can Stem Cell Therapy and Regenerative Medicine Contribute to the Protection or Recovery of the Injured Lungs?
		1 Introduction
		2 Alveolar and Airway Cell Lineages in Lung Repair and Regeneration
		3 Mesenchymal Stem/Stromal Cells
		4 Potential Mechanisms of Mesenchymal Stem Cell Actions in ARDS
		5 MSC Clinical Trials for ARDS and COVID-19
		6 Other Stem Cell Therapies
		7 Conclusion
		References
	Chapter 13: Imaging Technique for Ventilatory Management of ARDS Patients: Novel Monitoring Tool—Electrical Impedance Tomography
		1 Introduction
		2 Imaging Techniques
			2.1 Imaging Modality for Evaluation of Lung Morphology and Function
			2.2 EIT: The Difference from Other Modalities
		3 Roles of EIT in Clinical Practice
			3.1 Evaluation of Ventilatory Settings and the Effect of Therapeutic Interventions
				3.1.1 Ventilatory Settings in ARDS
				3.1.2 Therapeutic Interventions: Prone Position
				3.1.3 Evaluation of Therapeutic Interventions: ECMO
			3.2 Monitoring of Assisted Ventilation with Spontaneous Breathing
				3.2.1 Assessment of Ventilation with Respiratory Effort
				3.2.2 Therapeutic Interventions: Muscle Relaxant
			3.3 EIT-Guided Respiratory Management
		4 Conclusions
		References