Acute respiratory distress syndrome (ARDS).

The acute respiratory distress syndrome (ARDS) is a common clinical catastrophe following acute lung injury. A multiplicity of clinical states can lead to ARDS. A new classification system has been proposed to deal with associated organ system failure and varying degrees of acute lung injury. ARDS is a permeability and inflammatory edema with damage and destruction at the air blood interface. Many cellular and humoral mediators probably attack the lung's surfactant system which in turn enhances edema formation. Supportive care with mechanical ventilation and positive end expiratory pressure results with the salvage of less than 50% of patients. Lung regeneration requires weeks or months to become complete in those who survive. Thus far no individual pharmacological agents have been shown to alter prognosis. Controlled clinical trials are required to evaluate new and older pharmacological agents alone or in combination, and surfactant replacement.