Acute respiratory distress syndrome (ARDS)

Acute respiratory distress syndrome, or ARDS, is a highly lethal syndrome that is characterized by an overwhelming inflammatory response to infection or injury leading to diffuse alveolar damage and increased alveolar-capillary barrier permeability resulting in lung edema, impaired oxygenation, and hypoxemia. ARDS is a major public health problem and one of the leading causes of death in intensive care units (ICUs). ARDS may result from direct lung injury, such as that caused by bacterial pneumonia or following aspiration, but can also develop following indirect pulmonary injury associated with bacterial sepsis, trauma, or significant blood loss. Table 49.1 lists the most common causes of direct and indirect pulmonary injury that can precipitate the development of ARDS.