Morphometric Differences in Pulmonary Lesions in Primary and Secondary ARDSA Preliminary Study in Autopsies

Hoelz, C; Negri, Elnara M.; Lichtenfels, A.J.F.C.; Conceição, Gleice M.S.; Barbas, Carmen Sílvia Valente; Saldiva, Paulo Hilário Nascimento; Capelozzi, Vera L.

doi:10.1016/s0344-0338(04)70122-3

Cited by 40 publications

(34 citation statements)

References 20 publications

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“…Of note, ARDSp is characterized by the more pronounced alveolar collapse, fibrinous exudative material and edema of the alveolar walls, compared to ARDSexp (75). Furthermore, ARDSp has an increased collagen content, with a prevalence of the extracellular matrix remodeling (76).…”

Section: Pathology Of Ardsmentioning

confidence: 99%

Definition and epidemiology of acute respiratory distress syndrome

Rezoagli¹,

Fumagalli²,

Bellani³

2017

Ann. Transl. Med.

166

127

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Fifty years ago, Ashbaugh and colleagues defined for the first time the acute respiratory distress syndrome (ARDS), one among the most challenging clinical condition of the critical care medicine. The scientific community worked over the years to generate a unified definition of ARDS, which saw its revisited version in the Berlin definition, in 2014. Epidemiologic information about ARDS is limited in the era of the new Berlin definition, and wide differences are reported among countries all over the world. Despite decades of study in the field of lung injury, ARDS is still so far under-recognized, with 2 out of 5 cases missed by clinicians. Furthermore, although advances of ventilator strategies in the management of ARDS associated with outcome improvements-such as protective mechanical ventilation, lower driving pressure, higher PEEP levels and prone positioning-ARDS appears to be undertreated and mortality remains elevated up to 40%. In this review, we cover the history that led to the current worldwide accepted Berlin definition of ARDS and we summarize the recent data regarding ARDS epidemiology.

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Section: Pathology Of Ardsmentioning

confidence: 99%

Definition and epidemiology of acute respiratory distress syndrome

Rezoagli¹,

Fumagalli²,

Bellani³

2017

Ann. Transl. Med.

166

127

View full text Add to dashboard Cite

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“…Morphological evaluation was performed using well-established criteria for lung injury and diffuse alveolar damage, including septal thickening, alveolar inflammatory cell infiltration, and architectural disruption with increased interstitial cellularity. 21,22 Each criterion was scored from 0 to 3, and an average score was calculated for each sample for statistical analysis.…”

Section: Histology Scoringmentioning

confidence: 99%

Claudin-4 Levels Are Associated with Intact Alveolar Fluid Clearance in Human Lungs

Rokkam

LaFemina

Lee

et al. 2011

The American Journal of Pathology

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“…In 1994, the American-European Consensus Conference (2) defined two pathogenetic pathways leading to ARDS as a direct ("primary" or "pulmonary") insult, that directly affects lung parenchyma, and an indirect ("secondary" or "extrapulmonary") insult, that results from an acute systemic inflammatory response (5,6). The pathologic features of the lung in ARDS derive from severe injury to the alveolocapillary unit.…”

Section: Introductionmentioning

confidence: 99%

Corticosteroids in acute respiratory distress syndrome

Fernandes

Zin

Rocco

2005

Braz J Med Biol Res

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Improving the course and outcome of patients with acute respiratory distress syndrome presents a challenge. By understanding the immune status of a patient, physicians can consider manipulating proinflammatory systems more rationally. In this context, corticosteroids could be a therapeutic tool in the armamentarium against acute respiratory distress syndrome. Corticosteroid therapy has been studied in three situations: prevention in high-risk patients, early treatment with high-dose, short-course therapy, and prolonged therapy in unresolving cases. There are differences between the corticosteroid trials of the past and recent trials: today, treatment starts 2-10 days after disease onset in patients that failed to improve; in the past, the corticosteroid doses employed were 5-140 times higher than those used now. Additionally, in the past treatment consisted of administering one to four doses every 6 h (methylprednisolone, 30 mg/kg) versus prolonging treatment as long as necessary in the new trials (2 mg kg -1 day -1 every 6 h). The variable response to corticosteroid treatment could be attributed to the heterogeneous biochemical and molecular mechanisms activated in response to different initial insults. Numerous factors need to be taken into account when corticosteroids are used to treat acute respiratory distress syndrome: the specificity of inhibition, the duration and degree of inhibition, and the timing of inhibition. The major continuing problem is when to administer corticosteroids and how to monitor their use. The inflammatory mechanisms are continuous and cyclic, sometimes causing deterioration or improvement of lung function. This article reviews the mechanisms of action of corticosteroids and the results of experimental and clinical studies regarding the use of corticosteroids in acute respiratory distress syndrome.

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Morphometric Differences in Pulmonary Lesions in Primary and Secondary ARDSA Preliminary Study in Autopsies

Cited by 40 publications

References 20 publications

Definition and epidemiology of acute respiratory distress syndrome

Definition and epidemiology of acute respiratory distress syndrome

Claudin-4 Levels Are Associated with Intact Alveolar Fluid Clearance in Human Lungs

Corticosteroids in acute respiratory distress syndrome

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