The acute respiratory distress syndrome after major cardiac surgery - Case report
Acute respiratory distress syndrome (ARDS) is a severe pulmonary disease first described in 1967 by Dr. Thomas L. Petty and colleagues as a syndrome of respiratory failure that presents with progressive arterial hypoxemia refractory to oxygen therapy, severe dyspnea caused by reduction of pulmonary compliance and diffuse bilateral pulmonary infiltrations. This clinical syndrome is characterised by acute, severe and life threatening respiratory insufficiency with high mortality rate [1-3]. The definition of ALI/ARDS was recommended by the American/ European Consensus Conference since 1994 (Table 1). The standard definition classifies the patients with bilateral pulmonary infiltrates and arterial hypoxemia, who have the ratio of PaO2 / FiO2 less than 300 mmHg. However, if the ratio is less than 200 mmHg, the diagnosis of ARDS can be made. In patients with left heart disease, the pulmonary wedge pressure less that 18 mmHg is a criterion to distinguish ARDS form cardiac failure. Recently, new Berlin classification of ARDS was accepted in 2013, where the term ALI was abandoned and ARDS was categorized [3,4].