The widely used term "adult respiratory distress syndrome" (ARDS) as well as its underlying concepts are currently a subject of controversy. Introduced in 1971 by Petty and Ashbaugh1 as a name for the clinical disorder that they had previously reported,2 the term succeeded in replacing its competitors— "wet lung," "shock lung," "DaNang lung," and "pump lung"—but failed to gain unanimous approval. Some authorities are critical of the implied similarity to the infant "respiratory distress syndrome," which, at first, ARDS was mistakenly thought to resemble. Others object to the crowding of diverse disorders under the same terminological umbrella. There also may be those who are distressed by a descriptive label based on a subjective symptom.
Characterized by severe dyspnea, cyanosis, intractable hypoxemia, hypocapnia, wet lungs, reduced pulmonary compliance, increased capillary permeability, hemorrhagic exudates, alveolar collapse, hyaline membrane formation, and impaired gas transport, ARDS complicates a great variety of direct