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Review
. 2022 Oct 1;400(10358):1157-1170.
doi: 10.1016/S0140-6736(22)01439-8. Epub 2022 Sep 4.

Acute respiratory distress syndrome in adults: diagnosis, outcomes, long-term sequelae, and management

Ellen A Gorman  1 , Cecilia M O'Kane  1 , Daniel F McAuley  2
Affiliations
Review

Acute respiratory distress syndrome in adults: diagnosis, outcomes, long-term sequelae, and management

Ellen A Gorman et al. Lancet. .

Abstract

Acute respiratory distress syndrome (ARDS) is characterised by acute hypoxaemic respiratory failure with bilateral infiltrates on chest imaging, which is not fully explained by cardiac failure or fluid overload. ARDS is defined by the Berlin criteria. In this Series paper the diagnosis, management, outcomes, and long-term sequelae of ARDS are reviewed. Potential limitations of the ARDS definition and evidence that could inform future revisions are considered. Guideline recommendations, evidence, and uncertainties in relation to ARDS management are discussed. The future of ARDS strives towards a precision medicine approach, and the framework of treatable traits in ARDS diagnosis and management is explored.

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Conflict of interest statement

Declaration of interests EAG declares funding from the Wellcome Trust for work on a study investigating acute respiratory distress syndrome (ARDS) and COVID-19 and scholarship support from the American Thoracic Society to attend an American Thoracic Society meeting. DFM declares grants as an investigator in ARDS and COVID-19 studies from Wellcome Trust, the National Institute for Health and Care Research (NIHR), Innovate UK, the Medical Research Council, Novavax, and the Northern Ireland Health and Social Care Research and Development Fund; consultancy fees unrelated to this work from Bayer, GlaxoSmithKline, Boehringer Ingelheim, Novartis, and Eli Lilly; and payments from GlaxoSmithKline as an educational seminar speaker. DFM is a member of the data and safety monitoring board for Vir Biotechnology and Faron Pharmaceuticals; has a patent for a novel treatment for an inflammatory disease; is a director of research for the Intensive Care Society and director of the Efficacy and Mechanism Evaluation programme for the Medical Research Council and NIHR; declares a spouse who has received grants from Wellcome Trust and the Northern Ireland Health and Social Care Research and Development Fund; consultancy fees from INSMED and from the California Institute for Regenerative Medicine, unrelated to this Series paper. CMO’K declares grants as an investigator on studies related to ARDS and COVID-19 from Wellcome Trust and the Northern Ireland Health and Social Care Research and Development Fund; consultancy fees from INSMED, unrelated to this work, and fees for participation in grant panels for the Californian Institute of Regenerative Medicine, unrelated to this Series paper. CMO’K declares a spouse who has received grants from Wellcome Trust, the Northern Ireland Health and Social Care Research and Development Fund, NIHR, Innovate UK, the Medical Research Council, and Novavax; consultancy fees unrelated to this work from Bayer, GlaxoSmithKline, Boehringer Ingelheim, Novartis, and Eli Lilly; payments from GlaxoSmithKline as an educational seminar speaker; is a member of the data and safety monitoring board for Vir Biotechnology, Inc, and Faron Pharmaceuticals; has a patent for a novel treatment for an inflammatory disease; is a director of research for the Intensive Care Society and Director of the Efficacy and Mechanism Evaluation programme for the Medical Research Council and NIHR.

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