ABSTRACT
Acute respiratory distress syndrome (ARDS) is a disease of modern technology. Without oxygen supplementation and mechanical ventilation as well as modern diagnostic technology, patients with incipient respiratory failure cannot survive long enough to show more than the initial features of ARDS let alone have the diagnosis made. A number of risk factors are well known to affect the likelihood of developing ARDS as well as outcomes. As a syndrome, ARDS is associated with no one etiology or mechanism of injury. The more recent LUNG SAFE trial has shown overall hospital mortality rates in the 40% range for moderate and severe ARDS, corresponding to the ARDS category in the American European Consensus Conference definition of ARDS, and was also disappointing in this regard. Splitters often consider ARDS a “wastebasket” diagnosis which lumps too many different etiologies into the same bucket. Clinician recognition of ARDS was associated with higher positive end-expiratory pressure use, greater use of neuromuscular blockade, and prone positioning.
