Current challenges in understanding and treating ARDS: Three different perspectives

Research output: PhD ThesisPhd-Thesis - Research and graduation internal

Abstract

The Acute Respiratory Distress Syndrome (ARDS) is a clinically and biologically heterogeneous syndrome that contributes significantly to morbidity and mortality in critically ill patients.
This thesis covers three different perspectives to attain a deeper understanding of the pathophysiology and treatment of ARDS.
The first part addresses potentially beneficial therapeutic strategies targeting the pathophysiological hallmarks of ARDS: pulmonary coagulopathy and inflammation. More specifically, the aim was to systematically review nebulization of anticoagulants in acute lung injury, and to investigate the anticoagulant and/or anti-inflammatory effects of potentially therapeutic strategies in the preclinical setting.
The second part examines the impact of hepatic dysfunction in critically ill patients. As most cytokines and other mediators of the coagulation and inflammatory response are synthesized or metabolized by the liver, this part aimed to provide insight in the (patho)physiological interactions between lung and liver and to assess the impact of hepatic dysfunction on morbidity and mortality in critically ill patients.
In the final part of this thesis, we address methodological shortcomings in ARDS research contributing to the paucity of high–level evidence for therapeutic strategies. The aim was to systematically evaluate the heterogeneity between clinical ARDS trials with regards to reporting standards and trial outcome, and to illustrate why ARDS research is stuck in a generalizability crisis.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • University of Amsterdam
Supervisors/Advisors
  • Schultz, Marcus, Supervisor
  • Girbes, A. R. J., Supervisor, External person
  • Tuinman, Pieter R., Co-supervisor
  • Juffermans, Nicole, Co-supervisor
Award date9 Jun 2022
Print ISBNs9789464582376
Publication statusPublished - 2022

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