Risk Factors and Outcome in ARDS

The syndrome of acute respiratory failure now recognized widely as the adult respiratory distress syndrome (ARDS) has been known since World War I. It was first described as a type of acute respiratory failure that occasionally followed thoracic trauma. In reports around the time of World War II, the syndrome was identified in conjunction with severe trauma that again was usually sustained in wartime [1, 2]. In 1967, Ashbaugh and colleagues [3] first gave the syndrome a coherent framework in a clinical description of 12 patients. The mortality rate rose 58% in their patients. At that time it appeared that the majority of patients succumbed from respiratory failure or from complications directly related to it. Since that time, a number of studies have looked at survival associated with the syndrome, and all have reported a significant mortality rate ranging between 40 and 70%. Several studies have also looked at predictors of survival or mortality. The purpose of this chapter is to give information relative to the current epidemiology of ARDS. This information will include a current definition of the syndrome, discussion of clinical risk factors, complications and outcome.