Acute Respiratory Distress Syndrome (ARDS) and Hypoxemic Respiratory Failure

Acute respiratory distress syndrome (ARDS) is an acute inflammatory lung disorder that impairs gas exchange and leads to hypoxemia. Diagnosis is via the Berlin Criteria and includes an acute onset of hypoxemia due to a non-cardiogenic cause with compatible radiographic evidence of bilateral opacities not attributable to an alternate etiology. The mainstay of management in ARDS includes lung-protective ventilation, which targets low tidal volumes, low plateau pressures, and low driving pressure to avoid further lung damage. Rescue maneuvers for refractory hypoxemia may include prone positioning, paralysis, diuresis, pulmonary artery vasodilators, recruitment maneuvers, and, in rare cases, extracorporeal membrane oxygenation.