The maximum expression of hypoxia and hypoventilation: Acute respiratory distress syndrome

Abstract Over the past 50 years, it has been developed a well-defined conceptual model of ADRS, characterised by a diffuse alveolar damage caused by an injury in the pulmonary endothelium and alveolar epithelium. It is defined as a sudden respiratory failure, with the presence of bilateral opacities in imaging studies (typically in chest radiographies and computed tomographies), pulmonary oedema not fully explained by cardiac failure or liquid overload and hypoxaemia with a PaO2 /FiO2 < 300 mmHg with a positive end expiratory pressure (PEEP) > 5 cm H2 O. Its development has been described in the framework of numerous diseases and injuries, which are widely classified in pulmonary and extrapulmonary conditions; being pneumonia the most common risk factor to the development of this syndrome. Despite the advances in the management and prevention of ARDS, medical physicians are facing complications secondary to the treatment used, being the most characteristic ventilator induced lung injury, which not only increases lung damage but also has extrapulmonary repercussions, such as cardiac alterations.