Updates In Acute Respiratory Distress Syndrome

Abstract

Acute respiratory distress syndrome (ARDS) is a clinical entity characterized by widespread pulmonary injury following an inciting event. ARDS was first recognized in medical literature during the 1960s, and our knowledge of the disease and treatment has since then considerably advanced. The majority of patients who are diagnosed with ARDS ultimately require mechanical ventilation, and an estimated 10–15% of patients admitted to the intensive care unit (ICU) meet diagnostic criteria for severe ARDS. In this chapter, we present a comprehensive overview of ARDS with emphasis on the definition, etiology, pathophysiology, phenotypes, and management. The impact of medical innovations and scientific advances on the evolving definition of ARDS is explored through discussion of the parallels between medicine and technology. This concept is then linked to the myriad of ARDS etiologies which share a similar pathophysiological foundation. Expanding on this idea, we will focus on the ever-changing management of ARDS; importantly, this chapter will scrutinize the various viewpoints regarding mechanical ventilation strategies, prone ventilation, neuromuscular blockade, and extracorporeal membrane oxygenation (ECMO). This chapter concludes by discussion of prognosis and use of artificial intelligence in prognostication.