[Epidemiology and Pathophysiology of the acute respiratory distress syndrome (ARDS)].

Despite the implementation of a multimodal concept of treatment, the acute respiratory distress syndrome (ARDS) is still afflicted with high mortality rates. A reasonable application and combination of possible treatment strategies, such as prone position, positive end-expiratory pressure (PEEP), restrictive volume therapy or nitric oxide (NO), requires pathophysiological and epidemiological knowledge. In the following article we describe basic pathophysiological parameters in development, progression and therapy of ARDS. Furthermore, we try to elucidate possible reasons for considerable limitations of multicentric studies in this field.

[1]  T. Boes,et al.  Treatment of severe acute respiratory distress syndrome: role of extracorporeal gas exchange , 2006, Intensive Care Medicine.

[2]  C. Putensen,et al.  The impact of spontaneous breathing during mechanical ventilation , 2006, Current opinion in critical care.

[3]  G. Bernard,et al.  A randomized, controlled trial of furosemide with or without albumin in hypoproteinemic patients with acute lung injury* , 2005, Critical care medicine.

[4]  S. Oshima,et al.  Toxicity and roles of reactive oxygen species. , 2005, Current drug targets. Inflammation and allergy.

[5]  G. Martin,et al.  Understanding and managing fluid balance in patients with acute lung injury , 2004, Current opinion in critical care.

[6]  Edward Abraham,et al.  Neutrophils and acute lung injury , 2003, Critical care medicine.

[7]  G. Rubenfeld.  Epidemiology of acute lung injury , 2003, Critical care medicine.

[8]  M. Deja,et al.  Selective pulmonary vasodilation in acute respiratory distress syndrome , 2003, Critical care medicine.

[9]  S. Dzik.  Early goal-directed therapy in the treatment of severe sepsis and septic shock , 2002 .

[10]  Andrew D Bersten,et al.  Incidence and mortality of acute lung injury and the acute respiratory distress syndrome in three Australian States. , 2002, American journal of respiratory and critical care medicine.

[11]  R. Albert,et al.  Altering ventilation-perfusion relationships in ventilated patients with acute lung injury , 1997, Intensive Care Medicine.

[12]  R. Rossaint,et al.  High survival rate in 122 ARDS patients managed according to a clinical algorithm including extracorporeal membrane oxygenation , 1997, Intensive Care Medicine.

[13]  M. Lamy,et al.  The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. , 1994, American journal of respiratory and critical care medicine.

[14]  R. Rossaint,et al.  Inhaled nitric oxide for the adult respiratory distress syndrome. , 1993, The New England journal of medicine.

[15]  N. Staub.  Pulmonary edema: physiologic approaches to management. , 1978, Chest.

[16]  W. Zapol,et al.  Pulmonary hypertension in severe acute respiratory failure. , 1977, The New England journal of medicine.