ABSTRACT
The acute respiratory distress syndrome (ARDS) is associated with a
hospital mortality rate of 25% to 31% in recent large clinical trials (1,2), and 32% to 46% in the latest observational epidemiologic studies (3,4).
Comparison to historical controls is often problematic, but it certainly
appears that the mortality rate for ARDS has decreased over the past 15
to 20 years from rates of approximately 60%. Abel et al. examined the
change in mortality from ARDS in a single center, which used a standard
definition of ARDS, and found that mortality decreased from 66% to
34% during the last decade (5). The most likely explanation for the reduc-
tion in ARDS mortality is the use of lung-protective ventilatory strategies with smaller tidal volumes (VT) and the general enhanced quality of standard care in the intensive care unit.
