The adult respiratory distress syndrome.

ARDS is a pulmonary injury syndrome associated with a variety of clinical disorders. The pathophysiology of ARDS has been clarified substantially in the past several years. Neutrophils are probably the chief mediators of pulmonary injury, serving as the focus for release of several toxic substances that cause capillary endothelial and alveolar epithelial damage. The mortality rate in ARDS remains high despite advances in elucidating of pathogenesis. Newer approaches to management stress earlier identification of patients and specific therapy aimed at interfering with the damage produced by toxic mediators of pulmonary injury.