Acute respiratory distress syndrome

OBJECTIVE: To review the pathophysiology, epidemiology, and therapy of patients with acute respiratory distress syndrome (ARDS). DATA SOURCES: Articles pertaining to the pathophysiology, epidemiology, and supportive therapy of ARDS were chosen from a computerized literature search. Recent review articles addressing the specifics of treatment in an intensive care unit are cited rather than restating these specific aspects. DATA EXTRACTION: Primary literature was chosen in reference to the pathophysiology, epidemiology, and supportive therapy of ARDS. Both human and animal studies were included. Review articles were cited regarding areas of ARDS supportive therapy rather than citing the primary literature. STUDY SELECTION: Only peer-reviewed primary literature sources were chosen to describe the specifics of pathophysiology and epidemiology. When human data were unavailable, animal studies were cited. Recent review articles were cited for specifics on supportive therapy. DATA SYNTHESIS: Consensus regarding the definition of ARDS and the difficulties of performing large controlled trials in patients with ARDS has made development of new modalities problematic. Understanding the underlying pathophysiology and risk factors for mortality are key to supportive therapy. Although many pharmacologic agents are being tested in patients with ARDS, attention to the aspects of supportive therapy is the only method to decrease mortality. CONCLUSION: The mortality of ARDS continues to be 70%. Pharmacists can play an active role in the supportive therapy of patients with ARDS, which is currently the only way to impact mortality.