ACUTE RESPIRATORY-DISTRESS SYNDROME

OBJECTIVE: To review the pathophysiology, epidemiology, and therapy of patients with acute respiratory distress syndrome (ARDS). DATA SOURCE S: Articles pertaining to the pathophysioloqy, epidemiology, and suppo rtive therapy of ARDS were chosen from a computerized literature searc h. Recent review articles addressing the specifics of treatment in an intensive care unit are cited rather than restating these specific asp ects. DATA EXTRACTION: Primary literature was chosen in reference to t he pathophysiology, epidemiology, and supportive therapy of ARDS. Both human and animal studies were included Review articles were cited reg arding areas of ARDS supportive therapy rather than citing the primary literature. STUDY SELECTION: Only peer-reviewed primary literature so urces were chosen to describe the specifics of pathophysiology and epi demiology. When human data were unavailable, animal studies were cited . Recent review articles were cited for specifics on supportive therap y. DATA SYNTHESIS: Consensus regarding the definition of ARDS and the difficulties of performing large controlled trials in patients with AR DS has made development of new modalities problematic. Understanding t he underlying pathophysiology and risk factors for mortality are key t o supportive therapy. Although many pharmacologic agents are being tes ted in patients with ARDS, attention to the aspects of supportive ther apy is the only method to decrease mortality. CONCLUSIONS: The mortali ty of ARDS continues to be 70%. Pharmacists can play an active role in the supportive therapy of patients with ARDS, which is currently the only way to impact mortality.