The acute respiratory distress syndrome (ARDS) is a complex disorder associated with rapidly progressive lung inflammation, non-cardiogenic pulmonary edema, hypoxemic respiratory failure and one or more well-defined risk factors including sepsis and severe trauma. Since its original description in 1967, experimental and clinical evidence has provided considerable insight into the key roles deregulated systemic inflammation and coagulation play in this devastating clinical syndrome. Despite substantial advances in our understanding of the pathogenesis of ARDS, until recently, little progress had been made in uncovering clinical strategies to improve the outcome of patients with ARDS. However, over the past 10 years protective ventilation and other supportive management strategies have been identified that markedly improve the outcome in ARDS. More recently, research has identified patients at risk for the development of the syndrome. Currently, clinical trials are underway.
Table of Contents
Introduction
The Pathogenesis of ARDS
Experimental Models of ARDS
Resolution, Treatment, and Prevention of ARDS
References
About the Author(s)
Donna Carden, Department of Emergency Medicine, University of Florida College of Medicine
Donna Carden, M.D., is an emergency physician who completed internal and emergency medicine residencies at Henry Ford Hospital in Detroit, Michigan. Following residency training, Dr. Carden completed a post-doctoral research fellowship in the Department of Molecular and Cellular Physiology at Louisiana State University Health Sciences Center-Shreveport, Louisiana. Dr. Carden joined the faculty of the Departments of Physiology, Internal Medicine and Emergency Medicine at Louisiana State University Health Sciences Center-Shreveport where she studied the mechanisms responsible for acute lung injury following systemic inflammatory insults. She is currently Professor of Emergency Medicine at University of Florida, Gainesville and is completing a Master’s in Public Health degree with a focus on health services research.
Marie Elie, Department of Emergency Medicine, University of Florida College of Medicine
Marie Carmelle Elie, M.D. is an emergency physician who completed residency training at Mount Sinai Medical Center in New York and went on to complete a fellowship in trauma and critical care at the R. Adams Cowley Shock Trauma Center. In her training at one of the busiest trauma centers in the country, Dr. Elie became interested in the acute respiratory distress syndrome (ARDS), a frequent complication 2-3 days following acute, severe injury. During her fellowship, Dr. Elie mastered the use of novel ventilator strategies for ARDS and began to apply these modalities in critically ill patients in her role as a medical intensivist. Dr. Elie and a number of collaborators later endorsed the role of emergency medicine and anesthesiologists in identifying patients at risk for ARDS. She joined the U.S. Critical Illness and Injury Trials Group which devotes resources to the improvement of outcomes in critically ill patients. As part of the group, Dr Elie has served as an investigator on clinical trials aimed at the prevention of ARDS. In this role, she aims to provide education to scientists, students, and clinicians on potential life-saving protective interventions in the acutely injured and critically ill patients.
