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Acute Respiratory Distress Syndrome pp 15–27Cite as

Pathophysiology of Acute Respiratory Distress Syndrome

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Abstract

Important advances have been made in our understanding of acute respiratory distress syndrome (ARDS) pathophysiology, largely as the result of mechanistic studies about the most important cells involved in this condition, such as alveolar macrophages, neutrophils, and alveolar epithelial and endothelial cells. For each of these cell types, new pathways have been recognized in line with the clinical picture of ARDS, ranging from macrophage phenotypes, neutrophil extracellular traps, and antigen recognition by epithelial cells to specific surfactant release and biomarkers related to endothelial function. In the clinical setting, there is growing evidence for better ARDS phenotype recognition. It is clear that differences in biomarkers and prognosis exist between pulmonary and extrapulmonary phenotypes, as well as between traumatic, transfusion-related, cancer-related, and septic phenotypes. Such stratification has been done in other respiratory diseases, such as asthma and chronic obstructive pulmonary disease, with interesting results, and might improve outcomes in ARDS.

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  1. Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 373, Bloco G1-014, Ilha do Fundão, 21941-902, Rio de Janeiro, Brazil

    Pedro Leme Silva & Patricia R. M. Rocco MD, PhD

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Correspondence to Patricia R. M. Rocco MD, PhD .

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  1. Department of "Scienze della Salute", University of Milan, Director of Anaesthesia and Intensive Care Services , ASST Santi Paolo e Carlo, Milan, Italy

    Davide Chiumello

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Silva, P.L., Rocco, P.R.M. (2017). Pathophysiology of Acute Respiratory Distress Syndrome. In: Chiumello, D. (eds) Acute Respiratory Distress Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-319-41852-0_2

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