Principles & Practice of Mechanical Ventilation, 2e >John J. Marini

Mechanical Ventilation in the Acute Respiratory Distress Syndrome: Introduction

"Few areas of critical-care medicine have been the subject of as much investigative attention or clinical concern as the set of problems grouped under the label acuterespiratorydistresssyndrome (ARDS). This syndrome, first formally described in 1967,¹ continues to be recognized clinically as a rapidly developing impairment of pulmonary oxygen (O₂) exchange accompanied by diffuse infiltrates and altered respiratory system mechanics that cannot be attributed solely to hydrostatic forces. Fueled by better characterization of innate pathophysiology and of iatrogenic factors, considerable progress has been made in recent years toward reducing the adverse consequences of this condition. Yet, after almost four decades, active debate continues regarding key elements of the ventilatory prescription and appropriate therapeutic targets...."