Therapeutic agents for ARDS

Abstract

In spite of supportive care of patients with acute respiratory distress syndrome (ARDS), morbidity and mortality of these patients are considerable and effective therapies centred in ARDS pathophysiology are needed. Substantial progress in pharmacological therapies has been noticed, however, several studies have not been successfully translated to the clinics. Nonetheless, many preclinical and clinical studies are ongoing. In this review, pharmacological therapies underlying ARDS pathophysiology are summarized: therapies targeting the alveolocapillary membrane, mucolytics, bronchodilators, immunomodulators, anticoagulants and fibrinolytics, aspirin, and other treatments are discussed, including both, studies with beneficial and controversial results, and ongoing trials. In addition, a section concerning preclinical studies is included. An enlarged understanding of ARDS pathophysiology and its fundamental pathways and mechanism, together with the identification of ARDS subsets of patients and phenotypes will maximise patient response to a specific treatment.