Demographic, etiological, and histological pulmonary analysis of patients with acute respiratory failure: a study of 19 years of autopsies

Abstract

INTRODUCTION:Acute respiratory failure has been one of the most important causes of death in intensive care units, and certain aspects of its pulmonary pathology are currently unknown.OBJECTIVES:The objective was to describe the demographic data, etiology, and pulmonary histopathological findings of different diseases in the autopsies of patients with acute respiratory failure.METHOD:Autopsies of 4,710 patients with acute respiratory failure from 1990 to 2008 were reviewed, and the following data were obtained: age, sex, and major associated diseases. The pulmonary histopathology was categorized as diffuse alveolar damage, pulmonary edema, alveolar hemorrhage, and lymphoplasmacytic interstitial pneumonia. The odds ratio of the concordance between the major associated diseases and specific autopsy findings was calculated using logistic regression.RESULTS:Bacterial bronchopneumonia was present in 33.9% of the cases and cancer in 28.1%. The pulmonary histopathology showed diffuse alveolar damage in 40.7% (1,917) of the cases. A multivariate analysis showed a significant and powerful association between diffuse alveolar damage and bronchopneumonia, HIV/AIDS, sepsis, and septic shock, between liver cirrhosis and pulmonary embolism, between pulmonary edema and acute myocardial infarction, between dilated cardiomyopathy and cancer, between alveolar hemorrhage and bronchopneumonia and pulmonary embolism, and between lymphoplasmacytic interstitial pneumonia and HIV/AIDS and liver cirrhosis.CONCLUSIONS:Bronchopneumonia was the most common diagnosis in these cases. The most prevalent pulmonary histopathological pattern was diffuse alveolar damage, which was associated with different inflammatory conditions. Further studies are necessary to elucidate the complete pathophysiological mechanisms involved with each disease and the development of acute respiratory failure.

Acute respiratory distress syndrome: A study of autopsy findings

“…In the present study, we found bronchopneumonia in 36.2% ( n = 47/130) of cases along with ARDS, and in the study by Soeiro Ade et al ., they found an association with bronchopneumonia in 33.9% of cases. [ 20 ] Other common lung pathologies often seen in association with ARDS included pulmonary tuberculosis; in the present study, we found an association of 9.2% ( n = 12/130). The study by Raina et al .…”

Pesquisas em pneumologia recentemente publicadas em revistas brasileiras

“…Soeiro et al (29) reviewed the autopsies of 4,710 patients with acute respiratory failure. The authors found that bronchopneumonia and cancer were the two most common diagnoses.…”

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“…Their data showed no significant differences in lung function between bronchopulmonary dysplasia and no bronchopulmonary dysplasia patients at school age and no evidence of an association between atopy and bronchopulmonary dysplasia. Soeiro Ade et al (21) described the demographic data, etiology, and pulmonary histopathological findings of different diseases in the autopsies of 4,710 patients (age range: 1-99 years) with acute respiratory failure. Bronchopneumonia was the most common diagnosis in these cases.…”