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<p>Despite advancements in bedside monitoring and paradigm shifts in standard ventilatory practice, mortality from acute respiratory distress syndrome (ARDS) remains high. The recent Global ARDS definition adopts a more pragmatic approach enabling earlier identification across a broader patient spectrum, independent of the interventions being administered. Meanwhile, our understanding of managing this heterogeneous syndrome has shifted towards defining precise subgroups with shared therapeutic targets. Physiological, biological, and radiological phenotypes may modify the response to interventions previously showing indeterminate benefit, making them potentially central to future personalised ARDS management. This narrative review summarises core evidence for the medical and ventilatory management of ARDS, explores emerging concepts, and offers clinicians a framework for current best practice and a roadmap for possible future directions.</p>

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The medical management of acute respiratory distress syndrome

  • 期刊论文

  • 发表日期：

    2025年12月22日

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  • Idunn S. Morris,
  • Marcelo Amato,
  • Elias Baedorf Kassis,
  • Giacomo Bellani,
  • Carolyn S. Calfee,
  • Leo Heunks,
  • Carol Hodgson,
  • Priya Nair,
  • Ary Serpa Neto,
  • Sarina Sahetya,
  • Charlotte Summers,
  • Irene Telias,
  • Takeshi Yoshida,
  • Arthur S. Slutsky,
  • Niall D. Ferguson

摘要

Despite advancements in bedside monitoring and paradigm shifts in standard ventilatory practice, mortality from acute respiratory distress syndrome (ARDS) remains high. The recent Global ARDS definition adopts a more pragmatic approach enabling earlier identification across a broader patient spectrum, independent of the interventions being administered. Meanwhile, our understanding of managing this heterogeneous syndrome has shifted towards defining precise subgroups with shared therapeutic targets. Physiological, biological, and radiological phenotypes may modify the response to interventions previously showing indeterminate benefit, making them potentially central to future personalised ARDS management. This narrative review summarises core evidence for the medical and ventilatory management of ARDS, explores emerging concepts, and offers clinicians a framework for current best practice and a roadmap for possible future directions.