[Adult respiratory distress syndrome]

Adult respiratory distress syndrome (ARDS) represents an excessively dangerous acute respiratory failure, as result of diffuse damage of alveolocapillary membranes in stiff noncompliant lungs. ARDS is a widely disseminated syndrome caused by severe etiologic factors. ARDS usually appears within 12 to 72 hours of an identifiable clinical event and progresses through three phases: 1. exudative phase; 2. alveolar membrane damage and pulmonary surfactant systems; and 3. proliferative phase. Nearly all of the deaths occur within 30 days of the onset of the syndrome. The mortality rate varies according to the causes and the age. ARDS progresses through three clinical phases: 1. basis respiratory failure; 2. progressive respiratory failure; and 3. total respiratory failure. The therapy of ARDS is complex. It consists of: 1. background general therapy of ARDS; 2. background supportive therapy of ARDS; 3. definitive therapy to interrupt mechanisms of inflammation and pulmonary injury; 4. new pharmacologic supportive therapy.