ARDS and Sepsis: Resemblances and Differences

  • M. Lamy
  • G. Deby-Dupont
  • P. Damas
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 19)


While sepsis is an old problem, particularly in ICU, acute respiratory distress syndrome (ARDS) is a younger entity, first described in 1967 [1]. However, old or young, the two topics, sepsis and ARDS, are still the subject of numerous studies [2–4]. Among the infectious problems faced today by hospital physicians, gram-negative sepsis is perhaps the most serious one, with a frustrating high mortality rate, particularly when sepsis is complicated by shock. This is true despite intensive care, surgery, potent antibiotics and the new treatment modalities [5].


Septic Shock Acute Lung Injury Multiple Organ Dysfunction Syndrome Adult Respiratory Distress Syndrome European Collaborative Study 
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  1. 1.
    Ashbaugh DG, Bigelow DB, Petty TL, Levine BE (1967) Acute respiratory distress in adults. Lancet 2: 319–323PubMedCrossRefGoogle Scholar
  2. 2.
    Demling RH (1993) Adult respiratory distress syndrome: Current concepts. New Horizons 1 (3): 388–401PubMedGoogle Scholar
  3. 3.
    Goldsberry DT, Hurst JM (1993) Adult respiratory distress syndrome and sepsis. New Horizons 1 (2): 342–347PubMedGoogle Scholar
  4. 4.
    Martin MA, Silverman HJ (1992) Gram-negative sepsis and the adult respiratory distress syndrome. Clin Infect Dis 14: 213–218Google Scholar
  5. 5.
    Bone RC (1993) Gram-negative sepsis: A dilemma of modern medicine. Clin Microbiol Rev 6: 57–68PubMedGoogle Scholar
  6. 6.
    Bone RC (1992) Toward an epidemiology and natural history of SIRS (systemic in-flammatory response syndrome). JAMA 268: 3452–3455PubMedCrossRefGoogle Scholar
  7. 7.
    Bone RC (1992) Sepsis and multiple organ failure: Consensus and controversy. In: Lamy M, Thijs LG (eds) Mediators of Sepsis. Update in Intensive Care and Emergency Medicine, vol 16, Springer-Verlag, Berlin, pp 3–12Google Scholar
  8. 8.
    American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20: 864–874CrossRefGoogle Scholar
  9. 9.
    Bone RC (1991) The pathogenesis of sepsis. Ann Intern Med 115: 457–469PubMedGoogle Scholar
  10. 10.
    The European Society of Intensive Care Medicine (1994) The problem of sepsis. An Expert Report. Intensive Care Med 20: 300–304CrossRefGoogle Scholar
  11. 11.
    Bernard GR, Artigas A, Brigham KL, et al (1994) The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Crit Care Med 149: 818–824Google Scholar
  12. 12.
    Petty TL, Ashbaugh DG (1971) The adult respiratory distress syndrome: Clinical features, factors influencing prognosis and principles of management. Chest 70: 233–239CrossRefGoogle Scholar
  13. 13.
    Beale R, Grover ER, Smithies M, Bihari D (1993) Acute respiratory distress syndrome (“ARDS”): No more than a severe acute lung injury? Br Med J 307: 1335–1339CrossRefGoogle Scholar
  14. 14.
    Hudson LD (1989) Multiple systems organ failure (MSOF): Lessons learned from the adult respiratory distress syndrome (ARDS). Crit Care Clin 5: 697–705PubMedGoogle Scholar
  15. 15.
    Martin AM (1993) Nosocomial infections in intensive care units: An overview of their epidemiology, outcome, and prevention. New Horizons 1: 162–171PubMedGoogle Scholar
  16. 16.
    Wherry JC, Pennington JE, Wenzel RP (1993) Tumor necrosis factor and the therapeutic potential of anti-tumor necrosis factor antibodies. Crit Care Med 21: S436–S440PubMedCrossRefGoogle Scholar
  17. 17.
    Bone RC, Fisher CJ, Clemmer TP, Slotman CJ, Metz CA (1987) A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 317: 653–658PubMedCrossRefGoogle Scholar
  18. 18.
    Veterans Administration Systemic Sepsis Cooperative Study Group (1987) Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis. N Engl J Med 317: 659–665CrossRefGoogle Scholar
  19. 19.
    Greenman RL, Schein RMH, Martin MA, et al (1991) A controlled clinical trial of E5 murine monoclonal IgM antibody to endotoxin in the treatment of gram-negative sepsis. JAMA 266: 1097–1102PubMedCrossRefGoogle Scholar
  20. 20.
    Ziegler EJ, Fisher CJ, Sprung CL, et al (1991) Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin. N Engl J Med 324: 429–436PubMedCrossRefGoogle Scholar
  21. 21.
    Fisher CJ, Opal SM, Dhainaut JF, et al (1993) Influence of an anti-tumor necrosis mono-clonal antibody on cytokine levels in patients with sepsis. Crit Care Med 21: 318–327PubMedCrossRefGoogle Scholar
  22. 22.
    Kaplan RL, Sahn SA, Petty TL (1979) Incidence and outcome of the respiratory distress syndrome in gram-negative sepsis. Arch Intern Med 139: 867–869PubMedCrossRefGoogle Scholar
  23. 23.
    Pepe PE, Potkin RT, Reus DH, Hudson LD, Carrico CJ (1982) Clinical indications of the adult respiratory distress syndrome. Am J Surg 144: 124–130PubMedCrossRefGoogle Scholar
  24. 24.
    Fein AM, Lippmann M, Holtzman H, Eliraz A, Goldberg SR (1983) The risk factors, incidence, and prognosis of ARDS following septicemia. Chest 83: 40–42PubMedCrossRefGoogle Scholar
  25. 25.
    Weinberg PF, Matthay MA, Webster RO, et al (1984) Biologically active products of complement and acute lung injury in patients with the sepsis syndrome. Am Rev Respir Dis 130: 791–796PubMedGoogle Scholar
  26. 26.
    Langlois PF, Grawryl MS (1988) Accentuated formation of the terminal C5b-9 complement complex in patient plasma precedes development of the adult respiratory distress syndrome. Am Rev Respir Dis 138: 368–375PubMedGoogle Scholar
  27. 27.
    Luce JM, Montgomery AB, Marks JD, Turner J, Metz CA, Murray JF (1988) Ineffec-tiveness of high-dose methylprednisolone in preventing parenchymal lung injury and improving mortality in patients with septic shock. Am Rev Respir Dis 138: 62–63PubMedCrossRefGoogle Scholar
  28. 28.
    Bone RC, Slotman G, Maunder R, et al (1989) Randomized double-blind multicenter study of prostaglandin El in patients with the adult respiratory distress syndrome. Chest 96: 114–119PubMedCrossRefGoogle Scholar
  29. 29.
    Martin MA, Wenzel RP, Gorelick KJ, et al and the Xoma Sepsis Study Group (1990).Prospective US study of gram-negative bacterial sepsis-natural history in the 1980s. Circ Shock 31:245 (Abst)Google Scholar
  30. 30.
    Danner RL, Elin RJ, Hosseini JM, Wesley RA, Reilly JM, Parillo JE (1991) Endotoxemia in human septic shock. Chest 99: 169–175PubMedCrossRefGoogle Scholar
  31. 31.
    Hyers TM (1991) Adult respiratory distress syndrome: Definition, risk factors and out-come. In: Zapol WM, Lemaire F (eds) Adult respiratory distress syndrome, Marcel Dekker Inc, New York, pp 23–36Google Scholar
  32. 32.
    Thomsen GE, Morris AH, Danino D, Ellsworth J, Wallace CJ (1993) Incidence of the adult respiratory distress syndrome in Utah. Am Rev Respir Dis 147: A347 (Abst)Google Scholar
  33. 33.
    Villar J, Slutsky AS (1989) The incidence of adult respiratory distress syndrome. Am Rev Respir Dis 140: 814–816PubMedGoogle Scholar
  34. 34.
    Murray JF, Matthay MA, Luce JM, Flick MR (1988) An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis 138: 720–723PubMedGoogle Scholar
  35. 35.
    Hyers TM (1993) Prediction of survival and mortality in patients with adult respiratory distress syndrome. New Horizons 1: 466–470PubMedGoogle Scholar
  36. 36.
    Moore FA, Moore EE, Read RA (1993) Postinjury multiple organ failure: Role of extrathoracic injury and sepsis in adult respiratory distress syndrome. New Horizons 1: 538–549PubMedGoogle Scholar
  37. 37.
    Bell RC, Coalson JJ, Smith JD, Johansonn WG (1983) Multiple organ system failure and infection in the adult respiratory distress syndrome. Ann Intern Med 99: 293–298PubMedGoogle Scholar
  38. 38.
    Montgomery AB, Stager MA, Carrico CJ, Hudson LD (1985) Causes of mortality in patients with adult respiratory distress syndrome. Am Rev Respir Dis 132: 485–489PubMedGoogle Scholar
  39. 39.
    Artigas A, Carlet J, Le Gall JR, Chastang CL, Blanch L, Fernandez R (1991) Clinical presentation, prognostic factors and outcome of ARDS in the European Collaborative Study (1985-1987): A preliminary report. In: Zapol WM, Lemaire F (eds) Adult respiratory distress syndrome, Marcel Dekker, New York, pp 23–36Google Scholar
  40. 40.
    Thomas MH (1993) Prediction of survival and mortality in patients with adult respiratory distress syndrome. New Horizons 1: 466–470Google Scholar
  41. 41.
    Rinaldo JE, Heyman SJ (1990) ARDS, a multisystem disease with pulmonary manifes-tations. Crit Care Rep 1: 174–183Google Scholar
  42. 42.
    Lamy M, Fallat RJ, Koeninger EL, et al (1976) Pathologic feature and mechanisms of hypoxia in adult respiratory distress syndrome. Am Rev Respir Dis 114: 267–284PubMedGoogle Scholar
  43. 43.
    Fowler AA, Hamman RF, Good JP, et al (1983) Adult respiratory distress syndrome: Risk with common predispositions. Ann Intern Med 98: 593–597PubMedGoogle Scholar
  44. 44.
    Pontoppidan H, Hüttemeier PC, Quinn DA (1985) Etiology, demography and outcome. In: Zapol WM, Falke KJ (eds) Adult respiratory distress syndrome, Marcel Dekker, New York, pp 1–21Google Scholar
  45. 45.
    Suchyta MR, Clemmer TP, Elliott CG, Orme JF, Weaver LK (1992) The adult respiratory distress syndrome. A report of survival and modifying factors. Chest 101: 1074–1079PubMedCrossRefGoogle Scholar
  46. 46.
    Parrilo JE (1993) Pathogenetic mechanisms of septic shock. N Engl J Med 328: 1471–1477CrossRefGoogle Scholar
  47. 47.
    Damas P, Reuter A, Gysen P, Demonty J, Lamy M, Franchimont P (1989) Tumor necrosis factor and interleukin-1 serum levels during severe sepsis in humans. Crit Care Med 17: 975–978PubMedCrossRefGoogle Scholar
  48. 48.
    Standiford TI, Kunkel SL, Phan SH, et al (1991) Alveolar macrophage-derived cytokines induce monocyte chemoattractant protein-1 expression from human pulmonary type II-like epithelial cells. J Biol Chem 266: 9912–9918PubMedGoogle Scholar
  49. 49.
    Tracey KJ, Cerami A (1993) Tumor necrosis factor: An update review of its biology. Crit Care Med 21: S415–S422PubMedCrossRefGoogle Scholar
  50. 50.
    Wakabayashi G, Gelfand JA, Burke JF, Thompson RC, Dinarello CA (1991) A specific receptor antagonist for interleukin 1 prevents Escherichia coli - induced shock in rabbits. FASEB J 15: 338–343Google Scholar
  51. 51.
    Zimmerman GA, Prescott SM, Mclntyre TM (1992) Endothelial cell interactions with granulocytes: Tethering and signaling molecules. Immun Today 13: 93–99PubMedCrossRefGoogle Scholar
  52. 52.
    Beutler B, Grau GE (1993) Tumor necrosis factor in the pathogenesis of infectious disease. Crit Care Med 21: S423–S435PubMedCrossRefGoogle Scholar
  53. 53.
    Rinaldo JE, Christman JW (1990) Mechanisms and mediators of the adult respiratory distress syndrome. Clin Chest Med 11: 621–632PubMedGoogle Scholar
  54. 54.
    Neuhof H (1991) Actions and interactions of mediator systems and mediators in the pathogenesis of ARDS and multiorgan failure. Acta Anaesthesiol Scand 35 (Suppl 95): 7–14CrossRefGoogle Scholar
  55. 55.
    Lamy M, Deby-Dupont G, Deby C, et al (1992) Measurements of mediator cascades during adult respiratory distress syndrome. In: Artigas A, Lemaire F, Suter PM, Zapol WM (eds). Adult respiratory distress syndrome, Churchill Livingstone, London, pp 71–88Google Scholar
  56. 56.
    Tomasheski JF (1990) Pulmonary pathology of the adult respiratory distress syndrome. Clin Chest Med 11: 593–619Google Scholar
  57. 57.
    Matthay MA, Folkesson HG, Campagna A, Kheradmand F (1993) Alveolar epithelial barrier and acute lung injury. New Horizons 1: 613–623PubMedGoogle Scholar
  58. 58.
    Wortel CH, Doerschuk CM (1993) Neutrophils and neutrophil-endothelial cell adhesion in adult respiratory distress syndrome. New Horizons 1: 631–637PubMedGoogle Scholar
  59. 59.
    Tagan M, Markert M, Schaller M, Feihl F, Chiolero R, Perret C (1991) Oxidative metabolism of circulating granulocytes in adult respiratory distress syndrome. Am J Med 91: 72S–78SPubMedCrossRefGoogle Scholar
  60. 60.
    Strieter RM, Kunkel SL, Bone RC (1993) Role of tumor necrosis factor-a in disease states and inflammation. Crit Care Med 21: S447–S463PubMedCrossRefGoogle Scholar
  61. 61.
    Suter PM, Suter S, Girardin E, et al (1992) High bronchoalveolar levels of tumor necrosis factor and its inhibitors, interleukin-1, interferon, and elastase, in patients with adult respiratory distress syndrome after trauma, shock, or sepsis. Am Rev Respir Dis 145: 1016–1022PubMedCrossRefGoogle Scholar
  62. 62.
    Chollet-Martin S, Montravers P, Giebert C, et al (1993) High levels of interleukin-8 in the blood and alveolar spaces of patients with pneumonia and adult respiratory distress syndrome. Infect Immunol 61: 4553–4559Google Scholar
  63. 63.
    Donnelly SC, Strieter RM, Kunker SL, et al (1993) Interleukin-8 and development of adult respiratory distress syndrome in at-risk patient groups. Lancet 341: 643–647PubMedCrossRefGoogle Scholar
  64. 64.
    Marks JD, Marks CB, Luce JM, et al (1990) Plasma tumor necrosis factor in patients with septic shock. Am Rev Respir Dis 141: 94–97PubMedGoogle Scholar
  65. 65.
    Said SI, Foda HD (1989) Pharmacologic modulation of lung injury. Am Rev Respir Dis 139: 1553–1564PubMedGoogle Scholar
  66. 66.
    Goldstein G, Luce JM (1990) Pharmacologic treatment of the adult respiratory distress syndrome. Clin Chest Med 11: 773–787PubMedGoogle Scholar
  67. 67.
    Lamy M, Deby-Dupont G, Deby C, Faymonville ME, Damas P (1990) Why is our present therapy for adult respiratory distress syndrome so ineffective? In: Aochi O, Amaha K, Takeshita H (eds) Intensive and critical care medicine, Elsevier, Amsterdam, pp 11–26Google Scholar
  68. 68.
    Jepsen S, Herlevsen P, Knudsen P, Bud MI, Klausen NO (1992) Antioxidant treatment with N-acetylcysteine during adult respiratory distress syndrome: A prospective, ran-domized, placebo-controlled study. Crit Care Med 20: 918–923PubMedCrossRefGoogle Scholar
  69. 69.
    Christman BW, Bernard GR (1993) Antilipid mediator and antioxidant therapy in adult respiratory distress syndrome. New Horizons 1: 623–630PubMedGoogle Scholar
  70. 70.
    Slotman GJ, Fisher CJ, Bone RC, et al (1993) Detrimental effects of high-dose methyl- prednisolone sodium succinate on serum concentrations of hepatic and renal function indicators in severe sepsis and septic shock. Crit Care Med 21: 191–195PubMedCrossRefGoogle Scholar
  71. 71.
    Zapol WM, Hurford WE (1993) Inhaled nitric oxide in the adult respiratory distress syndrome and other lung diseases. New Horizons 1: 638–650PubMedGoogle Scholar
  72. 72.
    Dinarello CA, Gelfand JA, Wolff SM (1993) Anticytokine strategies in the treatment of the systemic inflammatory response syndrome. JAMA 269: 1829–1835PubMedCrossRefGoogle Scholar
  73. 73.
    Fink MP (1993) Adoptive immunotherapy of gram-negative sepsis: Use of monoclonal antibodies to lipopolysaccharide. Crit Care Med 2: S32–S39CrossRefGoogle Scholar
  74. 74.
    Exley AR, Cohen J, Buurman W, et al (1990) Monoclonal antibody to TNF in severe septic shock. Lancet 335: 1275–1277PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • M. Lamy
  • G. Deby-Dupont
  • P. Damas

There are no affiliations available

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