The first detailed clinico-pathological description of ARDS
was provided by Ashbaugh and colleagues7
. It is widely
accepted that neutrophils play a key role in the
pathogenesis of ARDS. Neutrophils generate a range of
reactive oxygen intermediates (ROI) and histotoxic
granule contents such as elastases and collagenase which
cause damage to capillary endothelial cells and airway
epithelial cells8,9. As a result, there is marked increase in
the permeability of the alveolar-capillary membrane to
water, solutes, and plasma proteins. This is the defining
characteristic of ARDS.