History
Acute respiratory distress syndrome was first described in 1967 by Ashbaugh et al. Initially there was no definition, resulting in controversy over incidence and mortality. In 1988 an expanded definition was proposed which quantified physiologic respiratory impairment.
In 1994 a new definition was recommended by the American-European Consensus Conference Committee. It had two advantages: first, it recognizes that severity of pulmonary injury varies, and secondly, it is simple to use.
ARDS was defined as the ratio of arterial partial oxygen tension (PaO2) as fraction of inspired oxygen (FiO2) below 200 mmHg in the presence of bilateralinfiltrates on the chest x-ray. These infiltrates may appear similar to those of left ventricular failure, but the cardiac silhouette appears normal in ARDS. Also, the pulmonary capillary wedge pressure is normal (less than 18 mmHg) in ARDS, but raised in left ventricular failure.
A PaO2/FiO2 ratio less than 300 mmHg with bilateral infiltrates indicatesacute lung injury (ALI). Although formally considered different from ARDS, ALI is usually just a precursor to ARDS.
In 2012 the Berlin Definition of ARDS was published this did away with the ALI/ARDS differentiation. It opts instead to classify ARDS as Mild, Moderate or severe.
Read more about this topic: Acute Respiratory Distress Syndrome
Famous quotes containing the word history:
“In front of these sinister facts, the first lesson of history is the good of evil. Good is a good doctor, but Bad is sometimes a better.”
—Ralph Waldo Emerson (1803–1882)
“Considered in its entirety, psychoanalysis won’t do. It’s an end product, moreover, like a dinosaur or a zeppelin; no better theory can ever be erected on its ruins, which will remain for ever one of the saddest and strangest of all landmarks in the history of twentieth-century thought.”
—Peter B. Medawar (1915–1987)
“The only thing worse than a liar is a liar that’s also a hypocrite!
There are only two great currents in the history of mankind: the baseness which makes conservatives and the envy which makes revolutionaries.”
—Edmond De Goncourt (1822–1896)