ABSTRACT
The acute respiratory distress syndrome (ARDS) is characterized by increased permeability of the alveolar capillary membrane, diffuse alveolar damage, and the accumulation of proteinaceous alveolor edema. These pathological changes are accompanied by several physiological alterations including severe hypoxemia and a decrease in pulmonary compliance. ARDS is a relatively uncommon etiology of acute respiratory failure in the intensive care unit. In a 2-week survey of 36 intensive care units in France, ARDS accounted for only 6.9% of all admissions (1). Similarly, ARDS represented 18% of all the patients who required intubation and mechanical ventilation for more than 24 hours in an 8-week survey of 132 intensive care units in Sweden, Denmark, and Iceland (2). However, ARDS patients account for a disproportionately high amount of hospital resources due to the prolonged intensive care unit and length of hospital stays. In one observational study, ARDS patients who required mechanical ventilation for at least 7 days represented only 6% of intensive care unit (ICU) admissions yet comprised 33% of all intensive care unit patient-days and 24% of all hospital charges among intensive care unit patients (3).
