الفهرس 
Evolution of ARDS definitionOnly 14 pages are availabe for public view
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Abstract
Background: Over past decades there was multiple interventions that had been studied targeting better outcome for ARDS patient entity but till now there is no treatment that adopted widely rather than protective lung ventilation strategy. Review of literature suggests immunomodulatory effect of hypertonic saline and action of nebulized furosemide to alleviate dyspnea in terminal cancer patient.
Patients & methods: study carried in Ain shams university intensive care units from march 2015 to march 2017. 120 patients fulfilled criteria of ARDS divided randomly into four groups all received standard treatment of our centre including salbutamol nebulizer and intravenous methylprednisolone 1mg/kg then group A was control group and group B received hypertonic saline 2.7% nebulizer added to standard treatment, group C furosemide nebulizer added to standard treatment and group D hypertonic saline nebulizer and furosemide nebulizer in sequence added to standard treatment.
Parameters was measured daily including lung injury score, signs of respiratory distress ranging from respiratory rate >35, marked use of accessory muscles and presence of abdominal paradox, also number of patients needed mechanical ventilation and days of mechanical ventilation (invasive or non-invasive), ICU days and mortality rates.
Results: groups used hypertonic saline nebulizer showed more rapid decline of lung injury score than other groups which was statistically significant with P-value <0.05 and decreased incidence of mechanical ventilation and days of mechanical ventilation with p-value <0.05. Groups used furosemide nebulizer showed more rapid improvement of signs of respiratory distress, but ICU days and mortality rate didn’t change markedly.
Conclusion: the Use of Combining of Hypertonic Saline Nebulizer and/or Furosemide Nebulizer may be beneficial to Attenuate the manifestations of ARDS and we recommend their use.