Acute respiratory distress syndrome historical perspective: Difference between revisions
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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 [[Neonatal respiratory distress syndrome|infantile respiratory distress syndrome]].<ref name="pmid4143721">{{cite journal| author=Ashbaugh DG, Bigelow DB, Petty TL, Levine BE| title=Acute respiratory distress in adults. | journal=Lancet | year= 1967 | volume= 2 | issue= 7511 | pages= 319-23 | pmid=4143721 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4143721 }} </ref> In the [[case series]], 12 patients developed [[dyspnea]], [[tachypnea]], [[cyanosis]] refractory to oxygen therapy, decreased [[pulmonary compliance]], and diffuse [[Alveolar lung disease|alveolar infiltration]] following severe [[trauma]], [[virus|viral]] [[infection]], or [[acute pancreatitis]]. | 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 [[Neonatal respiratory distress syndrome|infantile respiratory distress syndrome]].<ref name="pmid4143721">{{cite journal| author=Ashbaugh DG, Bigelow DB, Petty TL, Levine BE| title=Acute respiratory distress in adults. | journal=Lancet | year= 1967 | volume= 2 | issue= 7511 | pages= 319-23 | pmid=4143721 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4143721 }} </ref> In the [[case series]], 12 patients developed [[dyspnea]], [[tachypnea]], [[cyanosis]] refractory to oxygen therapy, decreased [[pulmonary compliance]], and diffuse [[Alveolar lung disease|alveolar infiltration]] following severe [[trauma]], [[virus|viral]] [[infection]], or [[acute pancreatitis]]. | ||
Until the formulation of the Berlin Definition of ARDS in 2012, the most widely used definition | Until the formulation of the Berlin Definition of ARDS in 2012, the most widely used definition was devised by the American European Consensus Conference (AECC) in 1994. The AECC committee recommended the term [[acute lung injury|acute lung injury (ALI)]] to define 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 hypertension|pulmonary capillary hypertension]]. ARDS was reserved for the most severe end of this spectrum. | ||
The AECC criteria for ALI and ARDS were: | |||
*Acute onset, bilateral infiltrates on [[chest radiography]] | *Acute onset, bilateral infiltrates on [[chest radiography]] | ||
*[[pulmonary capillary wedge pressure|Pulmonary-artery wedge pressure]] of < 19 mm Hg or the absence of clinical evidence of [[right heart catheterization|left atrial hypertension]] | *[[pulmonary capillary wedge pressure|Pulmonary-artery wedge pressure]] of < 19 mm Hg or the absence of clinical evidence of [[right heart catheterization|left atrial hypertension]] | ||
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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 in 2012, the most widely used definition was devised by the American European Consensus Conference (AECC) in 1994. The AECC committee recommended the term acute lung injury (ALI) to define 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 criteria for ALI and ARDS were:
- Acute onset, bilateral infiltrates on chest radiography
- Pulmonary-artery wedge pressure of < 19 mm Hg or the absence of clinical evidence of left atrial hypertension
- Arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FIO2) ≤ 300 for ALI or ≤ 200 for ARDS
The AECC definition of ARDS was largely superseded by the Berlin Definition of ARDS, published in 2012 by the ARDS Definition Task Force.[4] In formulating their diagnostic criteria, the ARDS Definition Task Force removed the distinction between ALI and ARDS, choosing instead to risk-stratify ARDS according to severity, each with its own associated mortality risk based on data from a large patient population. According to the Berlin Definition, what was once ALI is now classified as mild ARDS.
References
- ↑ 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.
- ↑ 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.
- ↑ Ashbaugh DG, Bigelow DB, Petty TL, Levine BE (1967). "Acute respiratory distress in adults". Lancet. 2 (7511): 319–23. PMID 4143721.
- ↑ 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.