الفهرس 
Historical PerspectivesOnly 14 pages are availabe for public view
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Abstract
Acute respiratory distress syndrome (ARDS) is a common problem in ICU. It may be a complication to other wide spectrum of critical illness, firstly described by Ashbaugh and colleagues in 1967.
American - European Consensus Conference (AECC) defined two pathogenic pathways leading to ARDS, direct one (pulmonary) affects lung parenchyma and indirect one (extra-pulmonary) results from an acute systemic inflammatory response.
The exact incidence of ARDS is difficult to measure, in part due to intrinsic problems related to the definition, the lack of clinical diagnostic tests and also because ARDS remains largely undiagnosed. Seven percentage of patients in ICU develop ARDS and the last incidence varies from 11% to 23% per 100000 population. Mortality rate equal to 35- 60% according to the last studies of AECC.
Different etiologies of ARDS include direct causes that involve the lung as pneumonia, aspiration of gastric content, toxic inhalation, near drowning and indirect causes as burn, sepsis, pancreatitis and gynacological causes.
The clinical features of ARDS can occur acutely or gradually as, tachypnea, dysnea, cough, agitation, cyanosis and coarse crakles on chest. Acute respiratory distress syndrome is a syndrome of acute respiratory failure which is defined by radiological and physiological criteria in which, there is a wide damage of alveolar capillary membrane leading to severe hypoxia.
The majority of deaths in ARDS is due to multiorgan failure and only 40% of death is due to respiratory failure. So, treatment of ARDS depends mainly on treatment of underlying cause, low tidal volume mechanical ventilation with PEEP in addition to supportive care to avoid multiorgan failure.