Acute respiratory distress syndrome historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Brian Shaller, M.D. [2]

Overview

Although the pathologic features of acute respiratory distress syndrome (ARDS) were first documented in the 19th century, the modern definition of ARDS did not arise until the 1960s. In 2012, the Berlin Definition of ARDS became the standard diagnostic criteria and definition of the syndrome.

Historical Perspective

Although the first pathologic descriptions of what was likely ARDS date back to 1821,[1] our understanding of the distinct pathophysiologic features of ARDS evolved alongside the development of medical technologies that facilitated a more in-depth study of the syndrome. The advent of radiography permitted visualization of the bilateral pulmonary infiltrates (originally termed double pneumonia), while the development of arterial blood gas measurement and positive-pressure mechanical ventilation allowed for identification of the impaired oxygenation and reduced lung compliance that are now recognized as central features of ARDS.[2]

In 1967, Ashbaugh and colleagues first described the clinical entity "acute respiratory distress in adults" characterized by a clinical and pathological course of events remarkably similar to the infantile respiratory distress syndrome.[3] In the case series, 12 patients developed dyspnea, tachypnea, cyanosis refractory to oxygen therapy, decreased pulmonary compliance, and diffuse alveolar infiltration following severe trauma, viral infection, or acute pancreatitis.

Until the formulation of the Berlin Definition of ARDS, the most widely used definition was devised by the American European Consensus Conference (AECC) in 1994.[4] The AECC committee recommended the use of the term acute lung injury (ALI) for defining the syndrome of inflammation and increased permeability that is associated with a constellation of clinical, radiologic, and physiologic abnormalities that cannot be explained by, but may coexist with, left atrial or pulmonary capillary hypertension. ARDS was reserved for the most severe end of this spectrum.

The AECC definition of ARDS was superseded by the Berlin Definition from the ARDS Definition Task Force in 2012.[5]

References

  1. Laennec, René Théophile Hyacinthe, and Sir John Forbes. A Treatise on the Diseases of the Chest, and on Mediate Auscultation. Samuel S. and William Wood, 1838.
  2. Bernard GR (2005). "Acute respiratory distress syndrome: a historical perspective". Am J Respir Crit Care Med. 172 (7): 798–806. doi:10.1164/rccm.200504-663OE. PMC 2718401. PMID 16020801.
  3. Ashbaugh DG, Bigelow DB, Petty TL, Levine BE (1967). "Acute respiratory distress in adults". Lancet. 2 (7511): 319–23. PMID 4143721.
  4. “The American-European Consensus Conference on ARDS. Definitions, Mechanisms, Relevant Outcomes, and Clinical Trial Coordination. (ATS Journals).” Accessed July 12, 2016. http://www.atsjournals.org/doi/abs/10.1164/ajrccm.149.3.7509706.
  5. ARDS Definition Task Force. Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E; et al. (2012). "Acute respiratory distress syndrome: the Berlin Definition". JAMA. 307 (23): 2526–33. doi:10.1001/jama.2012.5669. PMID 22797452.

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