In ARDS

Abstract

Monitoring of cardiovascular system function is of cornerstone importance in patients with ARDS either to confirm the diagnosis of the syndrome or to detect any possible hemodynamic impairment. ARDS is by definition a form of non-cardiogenic pulmonary edema. However, heart dysfunction and hypoproteinemia frequently coexist, particularly in septic patients. The resulting hydrostatic edema, superimposed to the increased lung vascular permeability, further worsens oxygenation. Optimization of oxygen delivery, cardiac output, and pulmonary function mandate a cautious fluid management and a careful ventilatory strategy. In the present chapter, we will: Summarize the pathophysiology of the most frequent hemodynamic abnormalities seen in ARDS. Review indications, advantages, and limits of the available monitoring techniques. Provide basic treatment principles to optimize cardiovascular function in these patients.