Acute respiratory distress syndrome

Area of Science:

• Respiratory Medicine
• Critical Care Medicine
• Epidemiology

Background:

• Acute Respiratory Distress Syndrome (ARDS) remains a critical clinical challenge in respiratory medicine.
• Recent literature highlights significant variability in ARDS diagnosis and management globally.
• Epidemiological data suggest ARDS is underdiagnosed, particularly in low-income countries.

Purpose of the Study:

• To provide an overview of current clinical relevance in ARDS, focusing on definition, epidemiology, risk factors, prevention, and treatment.
• To highlight the need for revised ARDS definitions to improve global recognition and outcomes.
• To review recent findings on risk factors and the challenges in preventive and therapeutic strategies for ARDS.

Main Methods:

• Review of approximately 300 indexed articles on ARDS published between July 2015 and July 2016.
• Analysis of data from a large international multicentre prospective cohort study across 50 countries.
• Synthesis of findings related to ARDS definition, epidemiology, risk factors, prevention, and treatment.

Main Results:

• A strict application of ARDS definition criteria is crucial but complicated by diverse global resource settings.
• International data reveal ARDS is underdiagnosed, indicating substantial potential for management improvement.
• New risk factors include high ozone levels and low vitamin D; preventive drug trials (aspirin, statins) have been unsuccessful.
• Despite some promising therapies, ARDS mortality and long-term complications in survivors remain high.

Conclusions:

• A revision of the current ARDS definition is necessary to enhance global recognition and clinical outcomes.
• Effective drug-based preventive strategies for ARDS are still lacking.
• There is an urgent need for novel disease-modifying therapies to improve ARDS prognosis and reduce the burden of complications in survivors.