title: Pharmacological therapies for acute respiratory distress syndrome.
abstract: OBJECTIVE
  Despite recent advances in the management of patients with acute respiratory distress syndrome (ARDS) by using protective ventilator strategies, the mortality rate of ARDS remains high. The complexity of the pathogenesis and the heterogeneity of coexisting diseases in patients with ARDS require critical care physicians and researchers to search for multiple therapeutic approaches in order to further improve patient outcome. This review article therefore focuses on the recent studies in the field of pharmacological intervention in ARDS.
  
  
  RESULTS
  A number of approaches for pharmacological intervention have been evaluated in patients with ARDS, but most of them failed to reduce mortality or improve outcomes despite some promising observations seen in preclinical studies. Prior methods such as nitric oxide inhalation, neuromuscular blocking agents and corticosteroids may still have a place in the treatment, while novel therapeutic approaches including the use of angiotensin-converting enzyme inhibitors, statins and stem cells are currently under investigation.
  
  
  CONCLUSIONS
  Overall, there is no proven pharmacological therapy in ARDS, but some pharmacological interventions were associated with beneficial effects in certain subgroups of patients depending on the cause, underlying diseases, the concurrent supportive therapies and timing. Further clinical trials are warranted to assess multiple outcome measurement of the promising pharmacological interventions in selected patients with ARDS.
authors: aPulmonary Engineering Group, Department of Anesthesiology and Intensive Care Medicine, University Hospital Dresden, Germany bKeenan Research Center, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Departments of Anesthesiology, Medicine and Physiology, University of Toronto, Canada.
authors: Peter Markus
authors: PM
authors: Spieth
authors: Haibo
authors: H
authors: Zhang
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D016638:Critical Illness; D005260:Female; D005440:Fluid Therapy; D015316:Genetic Therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D009466:Neuromuscular Blocking Agents / Q000627:therapeutic use; D044623:Nutrition Therapy; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D033581:Stem Cell Transplantation; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000806:Angiotensin-Converting Enzyme Inhibitors; D000925:Anticoagulants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D006993:Hypnotics and Sedatives; D009466:Neuromuscular Blocking Agents; D011663:Pulmonary Surfactants