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[B ARDS: Acute Respiratory Distress in Adults (Hardcover)
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[B ARDS: Acute Respiratory Distress in Adults (Hardcover)
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Great progress has been made since the first description of the
acute respiratory distress syndrome by the Denver group in 1967
(Lancet). Although we introduced the term 'adult respiratory
distress syndrome' in our second and more detailed description of
the syndrome (ehest, 1971), this was probably amistake for the
simple reason that children also suffer the same syndrome fo11owing
acute lung insults. Today, the syndrome of acute respiratory
distress in adults (ARDS) is recognized as a worldwide problem, but
the prevalence of disease varies in different parts of the world. A
huge amount of research has focused on the mechanisms of acute lung
injury and yet the exact sequence of events and media tors in
inflammatory cascade, which result in acute respiratory failure
from ARDS, is not known but many possibilities exist. The
definition of ARDS has been gradua11y modified in recent years and
investigators around the world are now co11aborating in order to
establish more uniform concepts in identification, risk factors and
mechanisms of lung injury, which someday will result in improved
approaches to management. Already, at least some centers are
showing improved outcomes in ARDS, achieving an approximate 60%
survival rate. In the past, most large series documented only about
a 40% survivability taking a11 causes of ARDS. This apparent
progress is likely attributable to more meticulous and disciplined
care than any specific pharmacologic attack on the basic mechanism
resulting in ARDS.
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