Adult Respiratory-Distress Syndrome: Changing Concepts of Lung Injury and Repair

THE adult respiratory-distress syndrome (ARDS) — acute respiratory failure due to noncardiogenic pulmonary edema — is a complex sequela of shock, systemic sepsis, battlefield or highway trauma, viral respiratory infections, and many other insults. This disorder is particularly tragic because it often afflicts patients who are young and were previously healthy. Recognized only 14 years ago, the syndrome has since been found to be both common and lethal, affecting an estimated 150,000 persons each year and killing at least half of them despite current supportive therapy. 1 2 3 We will briefly summarize this extraordinary history and focus on recent progress in understanding . . .