• Pulmonary Clinical Trials
• Acute Lung Injury & Respiratory Failure

• Pulmonary Clinical Trials
• Acute Lung Injury & Respiratory Failure
• Pulmonary & Critical Care

Much investigation is ongoing to improve monitoring and therapeutic options for acute respiratory distress syndrome (ARDS), with more than 300 trials currently underway.

Niall D. Ferguson, MD, Critical Care Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada, discussed specific areas of research that are likely to shape our understanding and treatment of ARDS over the next 10 years. Table 1 lists the various issues discussed and their challenges.

In addition to these areas of interest, Dr. Ferguson highlighted the need for improved definitions for ARDS. He speculated that the failures of basic science translation may be due to application of therapeutics to heterogenous populations based on inadequate definitions and disease characterization. He stressed the need to make periodic revisions to the syndromic definitions, gradually incorporating basic science with maintenance of the genotype-phenotype link. He also emphasized the need for a large observational study of acute respiratory failure to further define ARDS and large, collaborative, randomized, controlled trials based on sound physiology.

Finally, Dr. Ferguson stated that there is a need for worldwide collaboration to plan for unpredictable and global events, such as severe acute respiratory syndrome. He highlighted the importance of larger trials to help plan for such events, and he cited a global initiative, InFACT, that is taking the lead in this arena.

In summary, ARDS is the subject of intense investigation on many fronts, from improved definitions to diagnostic tools to therapeutic options. As such, the research community is hopeful that these efforts will translate to meaningful advances in the identification and management of ARDS over the next decade.

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