The acute respiratory distress syndrome
Michael A. Matthay, … , Lorraine B. Ware, Guy A. Zimmerman
Michael A. Matthay, … , Lorraine B. Ware, Guy A. Zimmerman
Published August 1, 2012
Citation Information: J Clin Invest. 2012;122(8):2731-2740. https://doi.org/10.1172/JCI60331.
View: Text | PDF
Review Series

The acute respiratory distress syndrome

Abstract

The acute respiratory distress syndrome (ARDS) is an important cause of acute respiratory failure that is often associated with multiple organ failure. Several clinical disorders can precipitate ARDS, including pneumonia, sepsis, aspiration of gastric contents, and major trauma. Physiologically, ARDS is characterized by increased permeability pulmonary edema, severe arterial hypoxemia, and impaired carbon dioxide excretion. Based on both experimental and clinical studies, progress has been made in understanding the mechanisms responsible for the pathogenesis and the resolution of lung injury, including the contribution of environmental and genetic factors. Improved survival has been achieved with the use of lung-protective ventilation. Future progress will depend on developing novel therapeutics that can facilitate and enhance lung repair.

Authors

Michael A. Matthay, Lorraine B. Ware, Guy A. Zimmerman

×

Figure 2

Mortality in ALI and ARDS.

Options: View larger image (or click on image) Download as PowerPoint
Mortality in ALI and ARDS. Shown is the 60-day mortality reported over t...
Shown is the 60-day mortality reported over the last 11 years in randomized clinical trials from the ARDS Network. ARMA-12 refers to the mortality rate of 431 patients enrolled into the higher–tidal volume arm (12 ml tidal volume/kg predicted body weight), and ARMA-6 refers to the mortality of 430 patients enrolled in the lower–tidal volume arm (6 ml tidal volume/kg predicted body weight) of one study (97). FACTT fluid conservative refers to the mortality of the 500 patients enrolled into the fluid-conservative arm of the Fluid and Catheter Treatment Trial (120). ALTA and OMEGA refer to the combined mortalities of the 2 most recent trials (N = 517 in both trials combined), Albuterol for the Treatment of ALI (136) and Omega-3 Fatty Acid, Gamma-Linolenic Acid, and Antioxidant Supplementation in the Management of ALI or ARDS (138).