Treatment of severe acute respiratory distress syndrome: A final report ona phase I study

Adult respiratory distress syndrome (ARDS) has a high mortality, Its only e ffective treatment is respiratory therapy. If this fails mortality is proba bly 100 per cent. No other treatment for ARDS has proved effective includin g "magic bullets." Twenty patients suffering from ARDS secondary to trauma and/or sepsis failed to respond to treatment with mechanical ventilation an d positive end-expiratory pressure, On the assumption that disseminated int ravascular coagulation initiates ARDS by occluding the pulmonary microcircu lation with microclots, the patients were treated with plasminogen activato rs, The patients responded with significant improvement in partial pressure of oxygen in arterial blood. No bleeding occurred and clotting parameters remained normal. We conclude that ARDS can be safely treated with plasminog en activator.