AKUTNÍ RESPIRAČNÍ DISTRESS SYNDROM

Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome (ARDS) is the general term used for severe acute respiratory failure of diverseaetiology. It is associated with a high morbidity, mortality (50 - 70 %), and financial costs. Regardless of aetiology,the basic pathogenesis of ARDS is a systemic inflammatory response leading to a diffuse inflammatory process thatinvolves both lungs, thus causing diffuse alveolar and endothelial damage with increased pulmonary capillarypermeability and excessive extravascular lung water accumulation. ARDS is commonly associated with sepsis andmultiple organ failure. The clinical picture involves progressive hypoxaemia, radiographic evidence of pulmonaryoedema, decreased lung compliance and pulmonary hypertension. Despite the scientific and technological progressin critical care medicine, there is no specific ARDS therapy available at the moment and its management remainssupportive. Therapeutic goals include resolution of underlying conditions, maintenance of acceptable gas exchangeand tissue oxygenation and prevention of iatrogenic lung injury. Many new specific therapeutic strategies have beendeveloped, however, most of them require further scientific evaluation. The paper reviews definition, basicpathogenesis and pathophysiology of ARDS and discusses current concepts of therapeutic possibilities of ARDS.

Key words:
acute respiratory distress syndrome, acute lung injury, respiratory failure, systemic inflammation,mechanical ventilation.