• Ruari Greer.
• Department of Anaesthesia, Manchester Royal Infirmary, Oxford Road, Manchester, Lancashire, UK. Ruari.greer@cmft.nhs.uk
• Eur J Anaesthesiol. 2010 Mar 1; 27 (3): 226-32.

Background And ObjectiveThe objective of this review is to provide an comprehensive overview of the evolution of acute respiratory distress syndrome (ARDS) in cellular, animal and human models with specific reference to sepsis and haemorrhage. Within this work we have attempted to describe the temporal evolution of the disease process.ARDS is a complication of pulmonary and systemic disease and it can follow sepsis or haemorrhage. The definition of this condition states an acute onset and this review seeks to clarify the time course of that onset following sepsis and haemorrhage. The underlying pathophysiological mechanisms include activation of the immune response, neutrophil activation and sequestration of these into the alveolus with subsequent tissue damage and hypoxia.ResultsThe biological evolution of these processes from sepsis or haemorrhage has been well described and the earliest measurable changes in the process occur within 15 min with the clinical manifestations of the syndrome occurring within 12 h. The rapid development of this condition should be considered during the treatment of haemorrhagic or septic shock.

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