ARDS Acute Respiratory Distress in Adults

1. Front Matter

   Pages i-xviii

   PDF

2. Introduction and Overview

   1. Front Matter

      Pages 1-1

      PDF

   2. Introduction and Definition

      • John F. Murray

      Pages 3-12

   3. Epidemiology

      • Molly L. Osborne, Robert J. Meyer

      Pages 13-23

   4. Spectrum of Disease

      • Nicholas P. Curzen, Christopher Haslett, Timothy W. Evans

      Pages 25-35

   5. Diffuse Alveolar Damage

      • Bryan Corrin

      Pages 37-46

3. Basic Mechanisms

   1. Front Matter

      Pages 47-47

      PDF

   2. Mechanisms of Resolution of Lung Inflammation

      • Christopher Haslett

      Pages 49-68

   3. Complement, Endotoxin and Acute Lung Injury

      • Polly E. Parsons

      Pages 69-84

   4. Cytokines and Lung Injury

      • Daniel R. Smith, Robert M. Strieter, Steven L. Kunkel

      Pages 85-97

   5. Mechanisms of Neutrophil Mediated Injury

      • G. Scott Worthen, Gregory P. Downey

      Pages 99-114

   6. Adhesion Molecules

      • S. Craig Stocks, Ian Dransfield

      Pages 115-137

   7. Proteinases

      • Caroline A. Owen, Edward J. Campbell

      Pages 139-165

   8. Reactive Oxygen Species, Antioxidant Protection and Lung Injury

      • John M. C. Gutteridge, Gregory J. Quinlan

      Pages 167-195

   9. Epithelial Injury and Repair

      • Elizabeth L. Aronsen, John M. Shannon

      Pages 197-213

   10. Mechanisms of Scarring

       • Patricia J. Sime, Jack Gauldie

       Pages 215-231

   11. Secondary Infections in Acute Lung Injury

       • Galen B. Toews

       Pages 233-248

4. Physiology

   1. Front Matter

      Pages 249-249

      PDF

   2. Pulmonary Physiology of Acute Lung Injury

      • Peter D. Macnaughton

      Pages 251-262

   3. Surfactant System in Lung Injury

      • Patricia L. Haslam

      Pages 263-296

Great progress has been made since the first description of the acute respiratory distress syndrome by the Denver group in 1967 (Lancet). Although we introduced the term 'adult respiratory distress syndrome' in our second and more detailed description of the syndrome (ehest, 1971), this was probably amistake for the simple reason that children also suffer the same syndrome fo11owing acute lung insults. Today, the syndrome of acute respiratory distress in adults (ARDS) is recognized as a worldwide problem, but the prevalence of disease varies in different parts of the world. A huge amount of research has focused on the mechanisms of acute lung injury and yet the exact sequence of events and media tors in inflammatory cascade, which result in acute respiratory failure from ARDS, is not known but many possibilities exist. The definition of ARDS has been gradua11y modified in recent years and investigators around the world are now co11aborating in order to establish more uniform concepts in identification, risk factors and mechanisms of lung injury, which someday will result in improved approaches to management. Already, at least some centers are showing improved outcomes in ARDS, achieving an approximate 60% survival rate. In the past, most large series documented only about a 40% survivability taking a11 causes of ARDS. This apparent progress is likely attributable to more meticulous and disciplined care than any specific pharmacologic attack on the basic mechanism resulting in ARDS.

• Acute respiratory distress syndrome (ARDS)
• care
• children
• inflammation
• lung
• management
• outcome
• pharmacology
• research
• respiratory failure
• stress

• National Heart & Lung Institute, USA

  Timothy W. Evans

• Royal Brompton Hospital, London, UK

  Timothy W. Evans

• University of Edinburgh, Royal Infirmary, Edinburgh, UK

  Christopher Haslett

Policies and ethics