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The acute respiratory distress syndrome: incidence and mortality, has it changed?

Villar, Jesúsa,b,c; Sulemanji, Demetd,e; Kacmarek, Robert M.d,e

Current Opinion in Critical Care: February 2014 - Volume 20 - Issue 1 - p 3–9
doi: 10.1097/MCC.0000000000000057
RESPIRATORY SYSTEM: Edited by Peolo Pelosi

Purpose of review The purpose of this review is to examine and discuss the incidence and outcome of patients with the acute respiratory distress syndrome (ARDS). This is a challenging task, as there is no specific clinical sign or diagnostic test that accurately identifies and adequately defines this syndrome.

Recent findings This review will focus on published epidemiological studies reporting population-based incidence of ARDS, as defined by the American-European Consensus Conference criteria. In addition, the current outcome figures for ARDS patients reported in observational and randomized controlled trials will be reviewed. The focus will be on studies published since 2000, when the ARDSnet study on protective mechanical ventilation was published, although particular emphasis will be on those articles published in the last 24 months.

Summary On the basis of current evidence, and despite the order of magnitude of reported European and USA incidence figures, it seems that the incidence and overall mortality of ARDS has not changed substantially since the original ARDSnet study. The current mortality of adult ARDS is still greater than 40%.

aCIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid

bResearch Unit, Hospital Universitario Dr Negrin, Las Palmas de Gran Canaria, Spain

cKeenan Research Center at the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada

dDepartment of Respiratory Care, Massachusetts General Hospital

eDepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA

Correspondence to Robert M. Kacmarek, Department of Respiratory Care, Massachusetts General Hospital, 55 Fruit Street, Warren 1225, Boston, MA 02114, USA. Tel: +1 617 7244480; fax: +1 617 7244495; e-mail:

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