scholarly journals Acute Respiratory Distress Syndrome: An Autopsy Study

2014 ◽  
Vol 48 (1) ◽  
pp. 8-13
Author(s):  
Suchet Sachdev ◽  
Shobhana Pravin Pandit
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Female Gender ◽  
Age Group ◽  
Autopsy Study ◽  
Adult Age ◽  
Systemic Infections

ABSTRACT Aim To find out prevalence and the associated predisposing etiologic conditions of acute respiratory distress syndrome (ARDS) amongst autopsied cases. Setting and design The present study was a retrospective analysis of 125 cases of ARDS obtained at autopsy over a span of 4 years from 2000-2003. Materials and methods Data was retrieved from the postmortem record of the pathology department and the medical record department. A review of histology slides was done with diffuse alveolar damage (DAD) as the correlate of ARDS at histopathology. Results Prevalence of ARDS amongst autopsied cases was 3.15%. There were 60% cases in adult age group and of male gender; whereas 40% were children and of female gender. Almost 90% of cases succumbed to ARDS within a week of admission. The most common presenting features were of the respiratory system. The most common predisposing etiologic association was leptospirosis, septicemia and pneumonia. Conclusion Systemic infections were the most common predisposing etiologic conditions of ARDS at autopsy. How to cite this article Sachdev S, Pandit SP. Acute Respiratory Distress Syndrome: An Autopsy Study. J Postgrad Med Edu Res 2014;48(1):8-13.

Acute respiratory distress syndrome in patients with and without diffuse alveolar damage: an autopsy study

2015 ◽  
Vol 41 (11) ◽  
pp. 1921-1930 ◽  
Author(s):  
José A. Lorente ◽  
Pablo Cardinal-Fernández ◽  
Diego Muñoz ◽  
Fernando Frutos-Vivar ◽  
Arnaud W. Thille ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Autopsy Study

scholarly journals Fatal acute respiratory distress syndrome with diffuse alveolar damage: donor lymphocyte infusion imputability?

2016 ◽  
Vol 48 (6) ◽  
pp. 1794-1796 ◽  
Author(s):  
Colombe Saillard ◽  
Magali Bisbal ◽  
Antoine Sannini ◽  
Laurent Chow-Chine ◽  
Jean-Paul Brun ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Donor Lymphocyte Infusion

scholarly journals Acute Respiratory Distress Syndrome: 30 Years Later?

1999 ◽  
Vol 6 (1) ◽  
pp. 71-86 ◽  
Author(s):  
Olivier Lesur ◽  
Yves Berthiaume ◽  
Gilbert Blaise ◽  
Pierre Damas ◽  
Éric Deland ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Keratinocyte Growth Factor ◽  
Supportive Therapy ◽  
Alveolar Epithelium ◽  
Patient Positioning ◽  
Neutrophil Accumulation

Acute respiratory distress syndrome (ARDS) was first described about 30 years ago. Modern definitions and statements have recently been proposed to describe ARDS accurately, but none is perfect. Diffuse alveolar damage is the basic pathological pattern most commonly observed in ARDS, and the term includes permeability edema. The alveolar epithelium of the alveolar-capillary barrier is clearly a key component requiring repair, given its multipotent functional activity. Lung inflammation and neutrophil accumulation are essential markers of disease in ARDS, and a wide variety of pro- and anti-inflammatory cytokines have been described in the alveolar fluid and blood of patients. These molecules still have to prove their value as diagnostic or prognostic biomarkers of ARDS.Supportive therapy in ARDS improved in the past decade; mechanical ventilation with lung protective strategies and patient positioning are gaining interest, but the indications for corticosteroids for ARDS are still debated. Nitric oxide may have a place in the treatment of one-third of patients. Novel approaches, such as surfactant replacement and liquid ventilation, may further improve supportive therapy. Innovative interventions may be on the horizon in treatments that help to resolve or modulate common pathways of ARDS, such as inflammation (eg, granulocyte-colony stimulating factor) or epithelial repair (eg, keratinocyte growth factor).

scholarly journals A Novel Swine Model of the Acute Respiratory Distress Syndrome Using Clinically-Relevant Injury Exposures

2021 ◽  
Author(s):  
Mohamad Hakam Tiba ◽  
Brendan M. McCracken ◽  
Danielle C. Leander ◽  
Carmen I. Colmenero ◽  
Jean A. Nemzek ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Direct Injection ◽  
Pathological Examination ◽  
Swine Model ◽  
Translational Study

AbstractTo date, existing animal models of the acute respiratory distress syndrome (ARDS) have failed to translate preclinical discoveries into effective pharmacotherapy or diagnostic biomarkers. To address this translational gap, we developed a high-fidelity swine model of ARDS utilizing clinically-relevant lung injury exposures. Fourteen male swine were anesthetized, mechanically ventilated, and surgically instrumented for hemodynamic monitoring, blood, and tissue sampling. Animals were allocated to one of three groups: 1) Indirect lung injury only: animals were inoculated by direct injection of E. coli into the kidney parenchyma, provoking systemic inflammation and distributive shock physiology; 2) Direct lung injury only: animals received volutrauma, hyperoxia, and bronchoscope-delivered gastric particles; 3) Combined indirect and direct lung injury: animals were administered both above-described indirect and direct lung injury exposures. Animals were monitored for up to 12 hours, with serial collection of physiologic data, blood samples, and radiographic imaging. Lung tissue was acquired post-mortem for pathological examination. In contrast to indirect lung injury only and direct lung injury only groups, animals in the combined indirect and direct lung injury group exhibited all of the physiological, radiographic, and histopathologic hallmarks of human ARDS: impaired gas exchange (mean PaO2/FiO2 ratio 124.8 ± 63.8), diffuse bilateral opacities on chest radiographs, and extensive pathologic evidence of diffuse alveolar damage. Our novel porcine model of ARDS, built on clinically-relevant lung injury exposures, faithfully recapitulates the physiologic, radiographic, and histopathologic features of human ARDS, and fills a crucial gap in the translational study of human lung injury.

scholarly journals Early veno-venous Extra Corporeal Membrane Oxygenation with prone positioning in the treatment of severe Acute Respiratory Distress syndrome in a pediatric patient: a case report

2019 ◽  
Vol 6 (4) ◽  
pp. 1743
Author(s):  
Md Nawad Azam ◽  
Senthil Kumar S. P.
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Adult Population ◽  
Age Group ◽  
Prone Positioning ◽  
Extra Corporeal Membrane Oxygenation ◽  
Membrane Oxygenation ◽  
Vv Ecmo

Aim of the study was to discuss effectiveness and outcome of Extra Corporeal Membrane Oxygenation (ECMO) therapy with prone positioning while on ECMO in a child with severe Acute Respiratory Distress Syndrome (ARDS). Veno-venous ECMO (VV-ECMO) and prone position on ECMO are relatively newer modalities of treatment in severe ARDS in pediatric age group and to our experience very few cases has been reported in paediatric age group. A 5 year old male child presented with fever with respiratory distress. He deteriorated in next 48 hrs leading to severe hypoxemia with ARDS following which he was put on conventional ventilation. In view of worsening critical lung parameters, veno-venous ECMO was initiated. Child had persistent hypoxemia inspite on high positive end expiaratory pressure (PEEP), adequate flow and adequate Post oxygenator PO2. Recirculation and other possible causes were excluded. Prone positioning (PP) was done for 8 hrs a day with chest physiotherapy while on ECMO. Patient showed considerable improvement in next few days and ECMO was weaned on day 7 and child was discharged on day 16 with good lung recovery. Although studies on VV-ECMO with PP has proven effectiveness in severe ARDS in adult population, overall studies in paediatric ARDS are very limited. Prone positioning on ECMO may decrease duration of ECMO support. Prone positioning on VV ECMO is safe and can be considered in Persistent hypoxemia with poor respiratory compliance.

scholarly journals A Model of Fatal Acute Lung Injury and Acute Respiratory Distress Syndrome

Biomeditsina ◽  
2020 ◽  
Vol 16 (4) ◽  
pp. 24-33
Author(s):  
I. A. Pomytkin ◽  
V. N. Karkischenko ◽  
Yu. V. Fokin ◽  
M. S. Nesterov ◽  
N. V. Petrova
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Mrna Level ◽  
Intratracheal Administration ◽  
Drug Candidates

This study was aimed at developing an experimental model of fatal acute lung injury and acute respiratory distress syndrome (ARDS) based on the intratracheal administration of bacterial lipopolysaccharide (LPS) in combination with muramylpeptide and Freund’s complete adjuvant to C57Bl/6Y mice sensitized with α-galactosylceramide. The developed model is characterized by diffuse alveolar damage to the lungs and high mortality rates, as well as by a multifold increase in the mRNA level of interleukin-6 in the lungs. The model can be used for assessing the efficacy of drug candidates in the treatment of acute lung injury and ARDS, including in COVID-19.

scholarly journals Diffuse Alveolar Damage Correlation with Clinical Diagnosis of Pediatric Acute Respiratory Distress Syndrome

2020 ◽  
Author(s):  
Esra Serdaroglu ◽  
Selman Kesici ◽  
Benan Bayrakci ◽  
Gulsev Kale
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Diffuse Alveolar Damage ◽  
Oxygenation Index ◽  
Consensus Conference ◽  
Clinical Criteria ◽  
European Consensus ◽  
Pulmonary Damage

AbstractDiffuse alveolar damage (DAD) is one of the pathological hallmarks of acute respiratory distress syndrome (ARDS). We aimed to compare pathological findings of DAD with clinical ARDS criteria. We re-evaluated 20 patients whose clinical autopsy revealed DAD. Total 11/20 patients with DAD (55%) met the 1994 American–European Consensus Conference and 7/17 (41%) met the 2012 Berlin clinical criteria. DAD showed only moderate correlation with current clinical ARDS definition. Oxygenation index (OI), seems to be the most valuable tool in predicting pulmonary damage severity, though OI is not listed in either of the previous definitions. We support the recommended use of OI by 2015 consensus conference.

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