The Acute Respiratory Distress Syndrome

Reviews21 September 2004The Acute Respiratory Distress SyndromeClaude A. Piantadosi, MD and David A. Schwartz, MD, MPHClaude A. Piantadosi, MDFrom Duke University Medical Center, Durham, North Carolina. and David A. Schwartz, MD, MPHFrom Duke University Medical Center, Durham, North Carolina.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-6-200409210-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Clinical PrinciplesSevere respiratory distress and 1 or more risk factors (including infection, aspiration, pancreatitis, and trauma)Impaired arterial oxygenation (hypoxemia)Bilateral pulmonary infiltrates on chest radiographNo clinical evidence of elevated left atrial pressure (or pulmonary artery occlusion pressure of ≤ 18 mm Hg if measurements are available)Physiologic PrinciplesThe cardinal feature of ARDS, refractory hypoxemia, is caused by formation of protein-rich alveolar edema after damage to the integrity of the lung's alveolar-capillary barrier.Alveolar-capillary damage in ARDS can be initiated by physical or chemical injury or by extensive activation of innate inflammatory responses. 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[PMID: 12149536] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Duke University Medical Center, Durham, North Carolina.Grant Support: By the National Heart, Lung, and Blood Institute, National Institutes of Health (PO1 HL 31992-18).Disclosures: None disclosed.Corresponding Author: Claude A. Piantadosi, MD, Division of Pulmonary and Critical Care Medicine, Box 3315, Duke University Medical Center, Durham, NC 27710; e-mail, [email protected]duke.edu.Current Author Addresses: Dr. Piantadosi: Division of Pulmonary and Critical Care Medicine, Box 3315, Duke University Medical Center, Durham, NC 27710.Dr. Schwartz: Division of Pulmonary and Critical Care Medicine, Box 2629, Duke University Medical Center, Durham, NC 27710. 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