Premium
LUNG PATHOLOGY IN RESPIRATORY DISTRESS FOLLOWING SHOCK IN THE ADULT
Author(s) -
Orell S. R.
Publication year - 1971
Publication title -
acta pathologica microbiologica scandinavica section a pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0365-4184
DOI - 10.1111/j.1699-0463.1971.tb00516.x
Subject(s) - hyaline , respiratory distress , medicine , lung , mechanical ventilation , diffuse alveolar damage , shock (circulatory) , pathology , respiratory system , lesion , pneumonia , respiratory failure , ventilation (architecture) , anesthesia , acute respiratory distress , mechanical engineering , engineering
Twenty cases of progressive respiratory distress (PRD) in adult patients following shock in connection with trauma, post‐operative complications or serious acute diseases are reviewed. The development of pulmonary consolidation with the formation of hyaline membranes (HM) in these cases is described in detail. Organization of the HMs may result in fibrous obliteration of respiratory bronchioles and alveolar ducts, if survival is sufficiently long. This is a highly characteristic picture. Thin HMs without organization, interpreted as early lesions, were found among twelve additional cases treated by artificial ventilation; these patients did not develop PRD but died of other causes. The relation of the pathological findings to certain clinical factors, such as length of survival with PRD, duration of mechanical ventilation and oxygen concentration, has been investigated. The results seem to concur with the theory that the pulmonary lesions are precipitated by inadequate tissue perfusion and possibly also intravascular coagulation during shock, leading to endothelial damage and reduced alveolar surfactant. Probably there are many important contributary factors, such as the mechanical effects of artificial ventilation, high oxygen concentration, infection, etc. “The respiratory distress lung” seems to be an appropriate morphological term for this type of lung lesion, which may also be precipitated by uraemia and viral pneumonia, for example, and greatly resembles the hyaline membrane disease in the newborn.