Acute respiratory distress syndrome since 1967 and still going strong

Authors

Keywords:

acute respiratory distress syndrome, ARDS

Abstract

Since its formal description as an entity in 1967, acute respiratory distress syndrome (ARDS) has been a constant and unwelcome companion to the critical care physician. Despite significant advances in ventilation practices, there has been little change in mortality in the last two decades. This trend may in part be due to ARDS having significant heterogeneity with physiological and pathological phenotypes that are fundamentally different and which current definitions do not discriminate between. Without clinical trials taking this into consideration, and the application of precision therapies to a targeted phenotype, progress with this syndrome will remain elusive. This narrative explores some of the current concepts relating to ARDS, and includes a discussion around the pairing of airway pressure release ventilation (APRV) with a specific phenotype as an example of “phenotype-specific treatment” based on physiological suitability and emerging evidence that supports the concept.

Author Biographies

O Smith, University of the Witwatersrand

Department of Anaesthesia, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand and Department of Critical Care, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa

GA Richards, University of the Witwatersrand

Department of Critical Care, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand and Department of Pulmonology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa

Downloads

Published

2021-11-15

Issue

Vol. 27 No. 6 (2021)

Section

FCA Refresher Course

License

By submitting manuscripts to SAJAA, authors of original articles are assigning copyright to the SA Society of Anaesthesiologists. Authors may use their own work after publication without written permission, provided they acknowledge the original source. Individuals and academic institutions may freely copy and distribute articles published in SAJAA for educational and research purposes without obtaining permission.

The work is licensed under a Creative Commons Attribution-Non-Commercial Works 4.0 South Africa License. The SAJAA does not hold itself responsible for statements made by the authors.