The diagnosis, pathogenesis, and treatment of adult respiratory distress syndrome.

ARDS is well recognized as a major medical emergency resulting in respiratory failure and refractory hypoxemia. The risk factors and attack rate of ARDS have been identified and principles of management established. The pathogenesis involves the release of toxic cell products that damage the air-blood interface, resulting in pulmonary edema, loss of functioning lung units, and reduced compliance. Today, management is supportive and results in the salvage of approximately 40% of patients suffering ARDS from all causes. Certain roentgenographic features can be identified in both acute and late phases of ARDS. The prognosis of survivors is favorable in the long term.