GOLDEN anniversary of the acute respiratory distress syndrome: still much work to do!

PURPOSE OF REVIEW: Over the past 50 years, we have developed a conceptual model of the acute respiratory distress syndrome (ARDS), and have witnessed significant advances in the care of patients with ARDS. In this commentary, we will discuss recent published articles reporting or suggesting new conceptual models for diagnosis, classification, stratification, prevention, ventilatory management, pharmacologic treatment, and outcome prediction of ARDS.

RECENT FINDINGS: This review is a tribute to all clinicians and investigators that have contributed to a better understanding of ARDS. However, we will mainly focus on publications from the last 24 months dealing with clinically relevant issues, and we briefly mention recent approaches in respiratory intensive care medicine that could improve ARDS outcome.

SUMMARY: Because this year is the golden anniversary of the first clinical description of ARDS in 1967, we have used the acronym 'G.O.L.D.E.N.' to frame our review. It is clear that although much has been learned over the past 50 years, there is still much work to do to unravel and control this continuously surprising syndrome.