Acute respiratory distress syndrome.

INTRODUCTION Acute respiratory distress syndrome (ARDS) is characterised by lung inflammation with severe hypoxia, which usually develops over 4-48 hours and persists for days or weeks. The main causes of ARDS are infections, aspiration of gastric contents, and trauma. Between a third and a half of people with ARDS die from the disease, but mortality depends on the underlying cause. Some survivors have long-term respiratory or cognitive problems. METHODS AND OUTCOMES We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions in adults with acute respiratory distress syndrome? We searched: Medline, Embase, The Cochrane Library and other important databases up to August 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. CONCLUSIONS In this systematic review we present information relating to the effectiveness and safety of the following interventions: corticosteroids, low tidal volume mechanical ventilation, nitric oxide, prone position, and protective ventilation.