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Updated: Jul 14, 2026
06:22
Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)
Published on: April 7, 2021
Acute respiratory distress syndrome
1Unit of Critical Care, Imperial College School of Medicine, Royal Brompton Hospital, London, UK.
Lancet (London, England)
|August 28, 1999
Summary
Outcomes in acute respiratory distress syndrome (ARDS) are complex. Improving survival may stem from rigorous treatment of underlying conditions and supportive care, rather than single-agent therapies.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Intensive Care
Background:
- Outcomes in acute respiratory distress syndrome (ARDS) are multifactorial, influenced by the precipitating condition and multiorgan failure.
- Previous therapeutic intervention studies in ARDS have been limited by small patient numbers and diverse pathologies.
- The timing and efficacy of single-agent interventions in the complex inflammatory process of ARDS remain questionable.
Purpose of the Study:
- To analyze factors influencing outcomes in acute respiratory distress syndrome (ARDS).
- To evaluate the effectiveness of current clinical trial designs and endpoints for ARDS.
- To explore reasons for observed improvements in ARDS survival.
Main Methods:
- Review of factors affecting ARDS outcomes, including precipitating conditions and organ failure.
- Analysis of limitations in previous ARDS therapeutic intervention studies.
- Discussion on the appropriateness of mortality as an endpoint versus ventilator-free days.
Main Results:
- Patient enrollment limitations and disease heterogeneity have hindered therapeutic trials.
- The evolving nature of ARDS inflammation challenges the utility of single-agent interventions.
- Survival in ARDS appears to be improving.
Conclusions:
- Mortality may be an inappropriate endpoint for ARDS clinical trials.
- Focus is shifting towards ventilator-free days as a more sensitive outcome measure.
- Improved ARDS survival is likely linked to protocol-driven supportive care and rigorous treatment of underlying causes.
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