Foundational Principles of ARDS

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Foundational Principles of ARDS

Objective

Equip the critical care pharmacist with a concise, high‐yield overview of ARDS epidemiology, predisposing factors, key pathophysiology, and clinical presentation to support exam prep and bedside decision making.

1. Epidemiology of ARDS

ARDS affects up to 10% of ICU admissions worldwide, yet is under‐recognized—especially in low-resource settings—leading to variable incidence and persistently high mortality.

Global incidence: Approximately 10% of ICU admissions; approximately 23% of ventilated patients.
Annual incidence: Approximately 79 cases per 100,000 population.
Regional variation: Higher reported rates in high-income vs. low-middle-income countries; under‐reporting where diagnostics and registries are limited.
Temporal trends: Awareness has improved since 2000 but ARDS remains a leading cause of acute hypoxemic respiratory failure.

2. Risk Factors and Predisposing Conditions

ARDS results from both direct lung insults (e.g., pneumonia, aspiration) and indirect systemic injuries (e.g., sepsis), with host factors and social determinants shaping individual risk and outcomes.

3. Pathophysiology of ARDS

4. Clinical Presentation and Differentiation

Berlin Definition of ARDS Severity by Oxygenation (with PEEP ≥5 cm H₂O)
Severity	PaO₂/FiO₂ Ratio (mmHg)
Mild	201–300
Moderate	101–200
Severe	≤100

References

Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. Lancet. 1967;2(7511):319–323.
Rubenfeld GD, Caldwell E, Peabody E, et al. Incidence and outcomes of acute lung injury. N Engl J Med. 2005;353(16):1685–1693.

2025 PACUPrep BCCCP Preparatory Course

Pulmonary

Participants 432

Foundational Principles of ARDS

Foundational Principles of ARDS

Objective

1. Epidemiology of ARDS

2. Risk Factors and Predisposing Conditions

3. Pathophysiology of ARDS

4. Clinical Presentation and Differentiation

References