Current concepts on the adult respiratory distress syndrome.

The shock- and trauma-induced process known as ARDS remains a major cause of mortality and morbidity. The time course of the clinical disease has changed dramatically as support systems have improved. In addition, it is becoming increasingly clear that ARDS is part of an inflammation-induced systemic disease state which can evolve to multi-system organ failure. It is MSOF which is now the leading cause of death in the post-trauma patient in the ICU. ARDS from shock and trauma must now be studied not solely as a primary pulmonary process but as a critical component of a generalized inflammatory reaction to distant tissue trauma.