الفهرس 
Evolution of ARDS definition
Epidemiological dataOnly 14 pages are availabe for public view
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Abstract
Acute respiratory distress syndrome (ARDS) remains a significant source of morbidity and mortality in the critically ill patient population. Over the past two decades, a variety of interventions and intensive care strategies have been used in treating patients with ALI/ARDS. Current pharmaco-therapy for ARDS is not optimal, and there is a significant need for more effective medicinal chemical agents for use in these severe and lethal lung injury syndromes. A number of pharmacologic agents have been studied individually in ARDS, with limited or minimal success in improving survival.
Hypertonic saline (HTS) may have Immunomodulatory effects as evidenced by reduction in the incidence of acute lung injury and infectious complications following hemorrhagic shock in patients whom are resuscitated by intravenous hypertonic saline. Clinically, inhaled hypertonic saline (HTS) is used to treat inflammation in cystic fibrosis (CF) and neonatal bronchiolitis. IL-8, a chemokine expressed by pulmonary epithelial cells and macrophages, is elevated in CF, and inhibited by hypertonic saline in vitro.
Review of literature showed a potential benefit of nebulized furosemide for relieving dyspnea, which is most common complaint in ARDS patients. Results of our conducted study suggested that HTS nebulizer may cause more rapid improvement of lung injury score when compared to control group but not statistically significant when compared to nebulized furosemide group.
The use of furosemide nebulizer either in group C and group D results in modest improvement in signs of respiratory distress when compared to control group especially in improvement of tachypnea, but didn’t result significant improvement when compared to HTS nebulizer such finding can be explained by improvement of patient condition is the major predictor for improvement of signs of respiratory distress.
HTS nebulizer has temporizing effect against disease progression giving that is reflected in our study in form of 50% reduction of the need of mechanical ventilation giving more time for lung to heal primarily without much burden of mechanical ventilation with it’s unwanted sequelae, as the most important issue of ARDS treatment is targeted against insulting factor not the disease itself.
The use of hypertonic saline and/or furosemide nebulizer didn’t significantly reduced mortality rates or the duration of ICU stay that showed statistically insignificant improvement than control group.