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:
“The myth of independence from the mother is abandoned in mid- life as women learn new routes around the mother—both the mother without and the mother within. A mid-life daughter may reengage with a mother or put new controls on care and set limits to love. But whatever she does, her child’s history is never finished.”
—Terri Apter (20th century)
“While the Republic has already acquired a history world-wide, America is still unsettled and unexplored. Like the English in New Holland, we live only on the shores of a continent even yet, and hardly know where the rivers come from which float our navy.”
—Henry David Thoreau (1817–1862)
“There is a history in all men’s lives,
Figuring the natures of the times deceased,
The which observed, a man may prophesy,
With a near aim, of the main chance of things
As yet not come to life.”
—William Shakespeare (1564–1616)