Transport en oxygène et syndrome de détresse respiratoire aiguë

The incidence of mortality is high in acute respiratory distress syndrome (ARDS) because of the frequent association with septic shock. Oxygen transport optimization in septic shock by volume expansion should be used carefully in patients with ARDS. Fluid replacement may indeed induce right ventricular failure and pulmonary edema. Different methods have been developed to minimize the deleterious effects of volume expansion while improving oxygen transport: predicting the effect of volume expansion on cardiac output, blood volume management, optimization of osmotic and hydrostatic pressures, and assessment of the permeability of the pulmonary vasculature. Eventually, the management of volemia in ARDS should be based on the optimization of oxygen transport that takes into account both the hemodynamic and the respiratory parameters.