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Previous Volume 332:27-37 January 5, 1995 Number 1 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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In this review we evaluate specific therapeutic strategies for the acute respiratory distress syndrome (ARDS)^1,2 and make recommendations on their use. We begin with a brief overview of the laboratory tests used to evaluate suspected cases of the syndrome, because these often dictate the subsequent therapeutic approaches. The clinical features, pathogenesis, and pathologic features of ARDS have been reviewed extensively elsewhere.^{3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18} We recognize that the understanding of ARDS and its optimal clinical management will continue to advance and that our recommendations will therefore be modified.

Definition of ARDS

The recent European–American Consensus Conference on ARDS developed the following working definition of "acute lung . . . [Full Text of this Article]

Laboratory Tests Used in Clinical Evaluation

Chest Radiography

Computed Tomography

Measurements of Gas Exchange

Measurements of Membrane Barrier Function and Extravascular Water

Bronchoalveolar Lavage

Hemodynamic Monitoring

Measuring Lung Injury in ARDS

General Therapeutic Measures

Nonpharmacologic Therapies

Mechanical Ventilation

Tidal Volume

PEEP

Ventilatory Rate

Inverse-Ratio Ventilation

Other Methods of Ventilation

Extracorporeal Respiratory Support

Positioning of the Patient

Fluid Management

Optimizing Oxygen Transport

Pharmacologic Therapies

Exogenous Surfactant

Corticosteroids

Antioxidants

Ketoconazole

Nitric Oxide

Eicosanoids and Their Inhibitors

Other Vasodilators and Vasoconstrictors

Pentoxifylline

Antiendotoxin and Anticytokine Therapy

Antibiotics

Management during the Recovery Phase

Summary

Source Information

From the Pulmonary and Critical Care Division, Department of Internal Medicine, Washington University Medical School, Box 8052, 660 S. Euclid Ave., St. Louis, MO 63110, where reprint requests should be addressed to Dr. Kollef.

References

Related Letters:

Acute Respiratory Distress Syndrome
Haller M., Schelling G., Briegel J., Mercat A., Teboul J.-L., Richard C., Blanch L., Fernández R., Mancebo J., Perret C. H., Gilston A., Schuster D. P., Kollef M. H.
Extract | Full Text  
N Engl J Med 1995; 332:1648-1650, Jun 15, 1995. Correspondence

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