Summary:
Acute respiratory distress syndrome (ARDS) is the general term used for severe acute respiratory failure of diverse
aetiology. It is associated with a high morbidity, mortality (50 - 70 %), and financial costs. Regardless of aetiology,
the basic pathogenesis of ARDS is a systemic inflammatory response leading to a diffuse inflammatory process that
involves both lungs, thus causing diffuse alveolar and endothelial damage with increased pulmonary capillary
permeability and excessive extravascular lung water accumulation. ARDS is commonly associated with sepsis and
multiple organ failure. The clinical picture involves progressive hypoxaemia, radiographic evidence of pulmonary
oedema, decreased lung compliance and pulmonary hypertension. Despite the scientific and technological progress
in critical care medicine, there is no specific ARDS therapy available at the moment and its management remains
supportive. Therapeutic goals include resolution of underlying conditions, maintenance of acceptable gas exchange
and tissue oxygenation and prevention of iatrogenic lung injury. Many new specific therapeutic strategies have been
developed, however, most of them require further scientific evaluation. The paper reviews definition, basic
pathogenesis and pathophysiology of ARDS and discusses current concepts of therapeutic possibilities of ARDS.
Key words:
acute respiratory distress syndrome, acute lung injury, respiratory failure, systemic inflammation,
mechanical ventilation.
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