title: Acute respiratory distress syndrome.
abstract: BACKGROUND
  Acute respiratory distress syndrome (ARDS) is characterised by a profound deterioration in systemic oxygenation or ventilation, or both, despite supportive respiratory therapy. ARDS is an acute and progressive respiratory disease of a non-cardiac cause that is associated with progressively diffuse bilateral pulmonary infiltrates, reduced pulmonary compliance, and hypoxaemia. The main causes of ARDS include direct lung injury (e.g., pneumonia, gastric acid aspiration) or indirect lung injury (e.g., sepsis, pancreatitis, massive blood transfusion, non-thoracic trauma). Sepsis and pneumonia account for about 60% of cases. Between one third and one 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
  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 December 2009 (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 20 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.
authors.affiliation: Section of Respirology, Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
authors.forename: Sat
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D006801:Humans; D000860:Hypoxia; D016684:Prone Position; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome; D013990:Tidal Volume
chemical_list: D000305:Adrenal Cortex Hormones