Acute Respiratory Distress Syndrome in the Perioperative Period of Cardiac Surgery: Predictors, Diagnosis, Prognosis, Management Options, and Future Directions
More research in the setting of ARDS after cardiac surgery is needed at multiple levels (risk factors, diagnosis, treatment options). Prevention of lung injury appears to be of the utmost importance, and a better characterization of the risk factors is needed. Avoiding excessive perioperative transfusions and the optimization of ventilation and hemodynamics seem to be the most modifiable risk factors. In patients who develop ARDS after cardiac surgery, extracorporeal techniques may represent a valid choice in experienced hands. The use of NMBAs, prone positioning, and iNO can be considered on a case-by-case basis, whereas aggressive lung recruitment and oscillatory ventilation probably should be avoided.
