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ARDS: A Clinical Syndrome or a Pathological Entity?

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Annual Update in Intensive Care and Emergency Medicine 2014

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM,volume 2014))

Abstract

Despite substantial advances in the understanding of the pathogenesis of the acute respiratory distress syndrome (ARDS), no specific pharmacologic treatment has been shown to affect outcome [1]. This failure has been attributed in part to a lack of a reliable definition for ARDS [2, 3]. Indeed, how the target population is defined for a clinical trial affects the results and their generalizability. Studies including patients with a low probability of responding to the treatment under study (because they are unlikely to have the diagnosis or because of other reasons) are likely to yield false-negative results [4, 5]. Thus a reliable definition of ARDS is essential for research (clinical trials, epidemiologic studies, and studies on pathogenesis) and for clinical practice (to reliably make a diagnosis of ARDS and provide appropriate treatment). In this context several relevant questions arise: What are the different diagnostic criteria for the definition of ARDS? What are the diagnostic test characteristics of these different criteria considering diffuse alveolar damage (DAD) as the histological reference for the diagnosis of ARDS? Does the clinical phenotype of ARDS correlate with one or with more histological entities? Is DAD the sole histological manifestation of ARDS?

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Author notes

  1. P. Cardinal-Fernández

    Present address: Department of Critical Care, Hospital Universitario de Getafe, Madrid, Spain

Authors and Affiliations

  1. Department of Critical Care, Hospital Universitario de Getafe, Madrid, Spain

    J. A. Lorente

  2. CIBER de Enfermedades Respiratorias, Madrid, Spain

    P. Cardinal-Fernández & J. A. Lorente

  3. Department of Pathology, Hospital Universitario de Getafe, Madrid, Spain

    A. Ballén Barragán

  4. Universidad Europea de Madrid, Madrid, Spain

    J. A. Lorente

Authors
  1. P. Cardinal-Fernández
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  2. A. Ballén Barragán
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  3. J. A. Lorente
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Corresponding author

Correspondence to J. A. Lorente .

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Editors and Affiliations

  1. Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent Prof.

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Cardinal-Fernández, P., Ballén Barragán, A., Lorente, J.A. (2014). ARDS: A Clinical Syndrome or a Pathological Entity?. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2014. Annual Update in Intensive Care and Emergency Medicine, vol 2014. Springer, Cham. https://doi.org/10.1007/978-3-319-03746-2_17

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  • DOI: https://doi.org/10.1007/978-3-319-03746-2_17

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-03745-5

  • Online ISBN: 978-3-319-03746-2

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