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Báo cáo khoa học: "Lung biopsy in ARDS: is it worth the risk"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Lung biopsy in ARDS: is it worth the risk? | Available online http ccforum.eom content 10 4 160 Commentary Lung biopsy in ARDS is it worth the risk Atul Malhotra1 and Sanjay Patel2 1 Pulmonary and Critical Care and Sleep Medicine Divisions Brigham and Women s Hospital and Harvard Medical School Boston MA USA 2Case Western Reserve University Cleveland OH USA Corresponding author Atul Malhotra amalhotra1@partners.org Published 29 August 2006 This article is online at http ccforum.com content 10 4 160 2006 BioMed Central Ltd Critical Care 2006 10 160 doi 10.1186 cc5001 See related research by Kao et al. http ccforum.com content 10 4 R106 Abstract Progress in the treatment of acute respiratory distress syndrome ARDS has been slow perhaps in part due to the heterogeneity in the biology underlying this syndrome. Open lung biopsy is a feasible approach to define various subcategories of underlying histology. In experienced hands with careful selection of patients and close attention to details of critical care management including mechanical ventilator settings the procedure is safe even in patients with severe disease. However further work is needed to define which patients if any experience a beneficial effect on outcome from this procedure. More research is needed on assessing efficacy of potential therapies within histologically defined subgroups. In the future various biomarkers may be available to non-invasively classify ARDS patients from the standpoint of responsiveness to various therapies such as glucocorticoids. In this issue of Critical Care Kao and colleagues 1 consider whether open lung biopsy OLBx can assist in the management of patients with acute respiratory distress syndrome ARDS . Clinical outcome in ARDS remains poor despite substantial advances in our understanding of the biology of this syndrome 2 . Although limiting transpulmonary pressure can clearly prevent worsening of ARDS no other major therapeutic advances with proven benefit have occurred in this area 3 . Progress has been limited .