The Etiology, Pathogenesis, and Pathological Anatomy of Diffuse Alveolar Lesion

Abstract

В настоящей статье рассматривается современная концепция диффузного альвеолярного повреждения (ДАП)достаточно часто встречающегося состояния, требующего проведения интенсивных терапевтических мероприя тий. Клиническим проявлением морфологии ДАП является респираторный дистресс синдром взрослых. Приведе ны причины возникновения ДАП-на фоне инфекционного процесса, включая септические состояния; ингаляций токсичных газов и аэрозолей; при шоке; действии радиации; лекарственной терапии и др. Подробно описан пато генез развития ДАП и патологическая анатомия, при этом характеризуются патологические изменения в легких на разных сроках от начала развития заболевания. The paper considers the current concept of diffuse alveolar lesion (DAL), a rather rare condition that requires intensive care measures. The clinicomorphological manifestation of DAL is adult respiratory distress syndrome. The causes of DAL occurring with an infectious process, including septic conditions, as well as with inhalations of toxic gases and aerosols; shock, radiation, drug therapy, etc. are presented. The pathogenesis of DAL and its pathological anatomy is described in detail, pathological lung alterations in different periods after the onset of the disease being characterized.

Helium Physicochemical "Recruitment" of Pulmonary Alveols in Prevention of Alveolar Collapse and Prevention of Acute Respiratory Distress in Patients with COVID-19

“…Antibiotics against viruses are ineffective and are not used in treatment. However, they can be prescribed for prophylaxis and in case of detection of bacterial secondary infection ( [3], p. [8][9][10][11][12][13][14][15][16][17][18]. The most common and dangerous complication of acute coronavirus pneumonia is ARDS.…”

“…It is believed that ARDS is characterized by diffuse alveolar damage ( [12], p. [13][14][15][16]. According to the modern concept, the term "diffuse alveolar injury" (DAP) is understood as a similar response of the lungs in acute injury of the airways of various etiologies.…”

“…It is based on necrosis of endothelial, epithelial cells and alveolar interstitium, leading to collapse (collapse) of the alveoli. In addition, this condition is characterized by a decrease in pulmonary compliance (the usual requirement for mechanical ventilation) and hypoxemia, requires intensive therapy and various techniques of mechanical ventilation ( [13], p. 61-78).…”

“…The causes of DAP as trauma (damage) can be aerosols of ammonia, nitrogen dioxide, herbicides, oxygen, zinc chloride, hydrogen sulfide, chemical warfare agents, phosgene and a number of drugs -amiodarone, nitrofurans, penicylamides, gold preparations, heroin and aero-sols -kerosene, herbicides, denatured rapeseed oil, etc. ; radiation; surgical conditionsshocks: traumatic, hemorrhagic, neurogenic, cardiogenic, sepsis, acute massive aspiration, acute pancreatitis; burns of the lungs with poisoning by combustion products; transfusion therapy, air embolism; drowning; unknown reasons and many others ( [13], p. 61-78; 14, p. 1334-1349). From the point of view of an incomplete list of etiological causes of development, the diagnosis of DAP corresponds to traumatic injury.…”

“…The hemodynamic characteristics of blood flow in the microvasculature and tissue blood flow were assessed. In healthy individuals in a hypoxic chamber filled with a respiratory gas mixture with a reduced concentration of oxygen and nitrogen, the addition of an inert gas argon to the respiratory mixture accelerated tissue microcirculation under conditions of hypoxia ([21], p. [13][14][15][16]. Since argon and helium are inert gases, the results obtained can be extrapolated to oxygen-helium breathing mixtures.…”