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| ARDS in its middle age:
What have we learned? Jesus Villar, Thomas L. Petty, Arthur S. Slutsky Since the first clinical description of the acute respiratory distress syndrome (ARDS), very few acronyms have become as popular and received as much attention in respiratory and critical care medicine. ARDS represents the study of injury and inflammation in the lung. As with inflammatory process elsewhere in the body, lung inflammation is accompanied by many cellular and biochemical processes; some of them may initiate the syndrome, others may perpetuate the syndrome and still others may inactivate the byproducts of inflammation. Today, there are more than fifty recognized conditions associated with the development of ARDS. Patients with ARDS provide clinicians with complicated and multifactorial problems. The current survival rate approximates 50% in all major series. It is assumed that mortality of ARDS patients will not be decreased until specific therapies or strategies are developed to prevent or attenuate the underlying inflammatory state and the development of extrapulmonary organ dysfunction. In this paper, we will review our current understanding of the epidemiology, pathophysiology, therapy and outcome of this fascinating syndrome. It will be an interesting 30-year journey from the mechanical ventilator to the molecule. Keywords: Acute lung injury, acute respiratory distress syndrome, cytokines, liquid ventilation, lung inflammation, mechanical ventilation, multiple system organ failure, nitric oxide, prone positioning, surfactant Applied Cardiopulmonary Pathophysiology 7: 167-172, 1998 Jesus Villar, M.D. |
| PABST SCIENCE PUBLISHERS Lengerich, Berlin, Düsseldorf, Leipzig, Riga, Scottsdale AZ (USA), Wien, Zagreb |
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