ABSTRACT
This chapter discusses widely regarded as the first description of acute respiratory distress syndrome (ARDS) in the literature. Mechanical ventilation strategies for ARDS utilized supraphysiologic tidal volumes which were felt to be adopted from the field of anesthesia, based on ventilation practices used during routine surgical cases to prevent atelectasis. In the 1980s and 1990s, chest computed tomography scans demonstrated that the pathologic process of ARDS was quite heterogeneous, with some areas of the lung affected, whereas other areas appeared to be free of disease. There are non-ventilatory methods that have been proven to be effective or show promise in the treatment of ARDS. In the 20 years since the publication of the ARDS net trial, low tidal volume and lung-protective ventilation strategies have become the standard of care for managing patients with acute lung injury. In a follow-up study, extrapulmonary organ dysfunction was less in the lung protection group.
