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Acute respiratory distress syndrome (ARDS)
1Presbyterian/Saint Luke's Center for Health Sciences Education, Denver, Colorado.
Disease-A-Month : DM
|January 1, 1990
Summary
Acute Respiratory Distress Syndrome (ARDS) is a severe lung injury. Current treatments like mechanical ventilation save less than 50% of patients, highlighting the need for new therapies.
Area of Science:
- Pulmonary Medicine
- Critical Care Medicine
- Pathophysiology
Background:
- Acute Respiratory Distress Syndrome (ARDS) is a critical condition following acute lung injury.
- Multiple clinical conditions can precipitate ARDS.
- A novel classification system addresses organ system failure and varying acute lung injury severity.
Purpose of the Study:
- To review the pathophysiology of ARDS.
- To discuss the current management strategies and their limitations.
- To emphasize the need for further clinical trials on pharmacological agents and surfactant replacement.
Main Methods:
- Literature review of ARDS pathophysiology and treatment.
- Analysis of existing classification systems.
- Discussion of supportive care, including mechanical ventilation and PEEP.
- Evaluation of current therapeutic interventions and research needs.
Main Results:
- ARDS involves increased lung permeability and inflammatory edema, damaging the air-blood interface.
- Cellular and humoral mediators likely impair the lung's surfactant system, worsening edema.
- Supportive care, including mechanical ventilation and positive end-expiratory pressure (PEEP), salvages fewer than 50% of patients.
Conclusions:
- Lung regeneration in survivors is a lengthy process (weeks to months).
- No single pharmacological agent has proven effective in altering ARDS prognosis to date.
- Controlled clinical trials are essential to evaluate novel and existing pharmacological agents, as well as surfactant replacement therapy.