RADICAL APPROACH TO THE ACUTE RESPIRATORY-DISTRESS SYNDROME

The acute respiratory distress syndrome continues to be a major medica l problem. Despite recent advances in treatment, such as the use of ni trogen monoxide (NO), extracorporeal membrane oxygenation (ECMO) and s pecialized ventilatory techniques in maintaining adequate oxygenation, mortality still remains high. The presence of activated neutrophils c oupled with high inspired oxygen concentrations provide conditions tha t favour increased oxidative stress and this has focused attention on the possible role of free radical species in both the initiation and p ropagation of ARDS. Although there is evidence implicating increased f ree radical activity in ARDS, much of this is from animal models and t he role of intervention in such processes has not been established. Al though antioxidant therapy has been suggested as a possible treatment for ARDS the current literature is less than convincing. We examine th e available data from human studies and suggest possible further studi es and future therapeutic goals.