The new trials of early goal-directed resuscitation: Three-part harmony or disharmony?

摘要

ARDS in the new Berlin classification has been defined as a heterogeneous syndrome with impairment of oxygena-tion not fully explained by cardiac failure or fluid overload with bilateral opacities at chest imaging not fully explained by effusions, lobar/lung collapse, or nodules [1]. From an anatomical point of view the lung in ARDS is characterized by the presence of both alveolar and pulmonary capillary injures which increase the pulmonary arterial pressure [2, 3]. The pulmonary vasculature is a low resistance, high capacitance system, which allows a high increase in blood flow without significant changes in pulmonary artery pressure.