Adult respiratory distress syndrome: current concepts.

The diffuse lung injury process known as adult respiratory distress syndrome (ARDS) remains a major cause of mortality and morbidity. The time course of the clinical disease has changed dramatically as support systems have improved. It is becoming increasingly clear that ARDS is part of an inflammation-induced systemic disease state that can evolve to multiple system organ failure. Multiple system organ failure is now the leading cause of death in the posttrauma 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.