The acute respiratory distress syndrome: Evolution of concepts and progress

Abstract

The acute respiratory distress syndrome (ARDS) is a common and catastrophic form of acute respiratory failure, caused by a number of direct and indirect insults to the lung. Inflammatory pulmonary edema and alveolar collapse are central to ARDS. Numerous redundant mechanisms are involved which include oxidants neutrophils products and other inflammatory mediators. Surfactant is damaged or destroyed. Supportive treatment with low tidal volume ventilation and positive end expiratory pressure is the standard of care. No specific pharmacologic agent has been shown to alter the course of disease. Survivors may have varying degrees of pulmonary insufficiency, or may be normal. Most survivors have a good prognosis and quality of life.