Acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS), first described a half century ago, remains a disease process resulting in significant morbidity and mortality throughout the world. Resulting in respiratory compromise, ARDS is the final common clinical pathway of multiple disease processes and can manifest as a result of both primary pulmonary (direct) and extrapulmonary (indirect) disease processes. In either scenario, treating the underlying inciting etiology is of paramount importance. The primary prevention of ARDS through early recognition of potentially inciting disease processes and the avoidance of overresuscitation (particularly in the setting of trauma) are preferred. Recent clinical trials have predominately clarified strategies that avoid the development of unintended iatrogenic injury rather than address the pulmonary process primarily. To this day, the treatment of ARDS remains largely supportive in nature.