RT Book, Section A1 Fish, Emily A1 Talmor, Daniel A2 Oropello, John M. A2 Pastores, Stephen M. A2 Kvetan, Vladimir SR Print(0) ID 1136413883 T1 The Acute Respiratory Distress Syndrome T2 Critical Care YR 1 FD 1 PB McGraw-Hill Education PP New York, NY SN 9780071820813 LK accessmedicine.mhmedical.com/content.aspx?aid=1136413883 RD 2024/10/08 AB KEY POINTSAcute respiratory distress syndrome (ARDS) is characterized by a severe inflammatory process, which causes diffuse alveolar epithelial and capillary damage.A number of medical and surgical conditions have been associated with the development of ARDS, with pneumonia and sepsis being the two most common predisposing conditions.The Berlin definition of ARDS includes four diagnostic criteria: (1) bilateral opacities on chest radiograph or computed tomography, (2) PaO2/FiO2 300 mm Hg or less with 5 cm or more H2O PEEP, (3) respiratory failure not fully explained by cardiogenic edema or volume overload, and (4) 7 days or less from predisposing clinical insult.Severity of ARDS is classified by the Berlin definition according to PaO2/FiO2: mild (201-300), moderate (101-200), and severe (< 100).Management strategies for ARDS are centered on treatment of the underlying clinical disorder while providing supportive care that minimizes ventilator-induced lung injury.Current clinical practice guidelines for reducing lung injury include low tidal-volume ventilation, application of PEEP (while maintaining plateau pressures < 30 cm H2O), and reduction of FiO2 to lowest necessary value to maintain a goal oxygen saturation of 88% to 95%.A number of novel therapies and ventilation strategies are currently under investigation.Despite significant advancements in the diagnosis and management of ARDS over the last two decades, mortality estimates remain more than 30% with significant morbidity among survivors.