Respiratory distress syndrome principles and current therapy

Acute respiratory distress syndrome (ARDS) describes a clinicopathologic disease process that occurs in association with a variety of clinical situations. The severity and outcome of this syndrome varies. Prolonged hospital stay, significant early morbidity and mortality, and long-term pulmonary parenchymal changes that result in reduced, often debilitating, pulmonary functions, typify the outcome of severe form of ARDS. Treatment is supportive with ventilatory assistance and adjunctive use of supplemental oxygen and end expiratory airway pressure (PEEP). Oxygen therapy and PEEP, though dramatically improve lung mechanics and oxygenation, are not innocuous and may adversely affect cardiovascular function and even induce pulmonary parenchymal injury. Over the years a variety of "lung protective" treatment modalities have been introduced and proved as effective and safe in the treatment of this syndrome.