Controversies in the definition of the acute respiratory distress syndrome

L. Azamfirei¹, Ruxandra Copotoiu¹, Raluca Solomon ²

1 Disciplina Anestezie-Terapie Intensivă, Universitatea de Medicină şi Farmacie Târgu-Mureş
2 Clinica Anestezie-Terapie Intensivă, Spitalul Clinic Judeţean de Urgenţă Mureş

Abstract

Despite intensive research, there are no universally accepted clinical definitions for acute lung injury (ALI) or the acute respiratory distress syndrome (ARDS). The goal of this article is to review the importance and value of standardized definitions of ARDS. The general accepted definitions have been widely used in practice and have served as the base for inclusion criteria for numerous clinical trials. Nevertheless, experts in this field continued to find new definitions, more appropriate to reflect our current understanding of the pathophysiology of this syndrome.

The American-European Consensus Conference on ARDS formally defined the difference between ALI and ARDS based on the degree of oxygenation impairment but neither this consensus no other previous definitions could reflect the true prevalence of the syndrom, the severity of lung damage or its prognosis. These definitions do not allow a precise staging of the syndrome and the used diagnostic criteria are very sensitive and non-specific. New definitions were offered for some terms, while other terms were dis-carded.
The development, implementation, evaluation, revision and reevaluation of standardized definitions are keys for improving the quality of future clinical trials in the field of critical care medicine.

Key words: ARDS, lung, oxygenation

J Rom Anest Terap Int 2010; 17: 42-48

ACTUALIZĂRI

Controverse în definirea sindromului de detresă respiratorie acută