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PedsCrit

PARDS--Beyond the Basics Part 4 with Dr. Nadir Yehya: Adjunctive Strategies (prone positioning, steroids, paralysis, iNO etc)

Jan 23, 2023
Dr. Nadir Yehya, an Assistant Professor of Anesthesiology and Critical Care and Pediatrics at the Perelman School of Medicine, discusses adjunctive strategies for treating ARDS, including corticosteroids, prone positioning, iNO, and surfactant. The podcast explores the benefits of these strategies in improving ventilation and oxygenation, and highlights the importance of weighing risks and potential benefits. Additionally, the use of nitric response, monitoring, and weaning protocol for ARDS patients is discussed, along with the use of surfactant and VV ECMO in ARDS management.
36:20

Episode guests

Podcast summary created with Snipd AI

Quick takeaways

  • Prone positioning can improve oxygenation and lung function by redistributing ventilation and perfusion in acute respiratory distress syndrome (ARDS).
  • The use of corticosteroids as an adjunct strategy in ARDS management can improve lung injury, compliance, and gas exchange, but their impact on mortality and side effects are still debatable and should be considered on an individual basis.

Deep dives

Adjunct strategies for ARDS treatment

The podcast discusses the use of adjunct strategies for the treatment of acute respiratory distress syndrome (ARDS). These adjunct strategies include corticosteroids, prone positioning, nitric oxide, and surfactant. Each strategy has its own potential benefits and considerations. Corticosteroids have been shown to improve lung injury in adults, but their impact on outcomes is still debated. Prone positioning redistributes ventilation and perfusion, improving oxygenation and lung function. Nitric oxide can improve ventilation-perfusion matching, while surfactant replacement therapy is more commonly used in neonatal respiratory distress syndrome. Overall, the choice of adjunct strategies depends on the specific clinical context and the risk-benefit balance.

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