The definition of acute respiratory distress syndrome (ARDS) by American-European Consensus Conference (AECC) in 1994 has promoted clinical and epidemiological research leading to improved survival outcome of the ARDS patients by establishing lung protective ventilation. On the other hand, no pharmacological therapy has yet proved to be effective despite substantial effort devoted to development and research. ⋯ Recently, a randomized trial and clinical experience in treating severe influenza have demonstrated favorable outcome of ECMO therapy in the management of severe ARDS. Future progress will depend on developing novel therapeutics that can ameliorate lung injury and systemic derangements and facilitate lung repair.
Department of Anesthesiology, The Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033.
Masui. 2013 May 1; 62 (5): 514-6.
AbstractThe definition of acute respiratory distress syndrome (ARDS) by American-European Consensus Conference (AECC) in 1994 has promoted clinical and epidemiological research leading to improved survival outcome of the ARDS patients by establishing lung protective ventilation. On the other hand, no pharmacological therapy has yet proved to be effective despite substantial effort devoted to development and research. Based on experimental and clinical studies, progress has been made in understanding the mechanisms responsible for the pathogenesis and the resolution of lung injury. Sophisticated imaging modalities such as high-resolution CT may be utilized as a marker to predict responsiveness to therapy and clinical course. Recently, a randomized trial and clinical experience in treating severe influenza have demonstrated favorable outcome of ECMO therapy in the management of severe ARDS. Future progress will depend on developing novel therapeutics that can ameliorate lung injury and systemic derangements and facilitate lung repair.