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Diffuse Alveolar Damage

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ARDS Acute Respiratory Distress in Adults

Abstract

At the time that the Denver team of Ash-baugh, Petty and colleagues were crystallizing their ideas on what they first referred to as acute respiratory distress in adults (ARDS) [I], and later termed the adult respiratory distress syndrome [2–4], Liebow was describing the pathology of the condition. The name that Liebow coined for the nonspecific changes of acute alveolar injury was diffuse alveolar damage (DAD) [5–6], a term that will be adhered to in this chapter. Previously, pathologists such as Moon had described similar changes in the lungs of patients dying of shock [7].

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References

  1. Ashbaugh, D.G., Bigelow, D.B., Petty, T.L. and Levine, B.E. (1967) Acute respiratory distress in adults. Lancet, ii, 319–23.

    Article  Google Scholar 

  2. Ashbaugh, D.G., Petty, T.L., Bigelow, D.B. and Harris, T.M. (1969) Continuous positive-pressure breathing (CPPB) in adult respiratory distress syndrome. J. Thome. Cardiovasc. Surg., 57, 31–41.

    CAS  Google Scholar 

  3. Petty, T.L. and Ashbaugh, D.G. (1971) The adult respiratory distress syndrome. Clinical features, factors influencing prognosis and principles of management. Chest, 60, 233–9.

    Article  PubMed  CAS  Google Scholar 

  4. Petty, T.L. (1975) The adult respiratory distress syndrome — confessions of a lumper’. Am. Rev. Respir. Dis., 111, 713–5.

    PubMed  CAS  Google Scholar 

  5. Liebow, A.A. (1967) New concepts and entities in pulmonary disease, in International Academy of Pathology monograph No.8, The Lung, Williams & Wilkins, Baltimore, pp. 332–65.

    Google Scholar 

  6. Katzenstein, A.A., Bloor, CM. and Liebow, A.A. (1976) Diffuse alveolar damage — the role of oxygen, shock and related factors. Am. J. Pathol, 85, 210–22.

    Google Scholar 

  7. Moon, V.H. (1948) The pathology of secondary shock. Am. J. Pathol., 24, 235–73.

    PubMed  CAS  Google Scholar 

  8. Corrin, B. (1980) Lung pathology in septic shock. J. Clin. Pathol, 33, 891–4.

    Article  PubMed  CAS  Google Scholar 

  9. Martin, A.M., Soloway, H.B. and Simmons, R.L. (1968) Pathologic anatomy of the lungs following shock and trauma. J. Trauma, 8, 687–99.

    Article  PubMed  Google Scholar 

  10. Bredenburg, C.E., James, P.M., Collins, et al. (1969) Respiratory failure in shock. Ann. Surg., 169, 392–403.

    Article  Google Scholar 

  11. Nash, G., Foley, F.D. and Langlinais, P.C. (1975) Pulmonary interstitial edema and hyaline membranes in adult burn patients. Hum. Pathol, 5, 149–60.

    Article  Google Scholar 

  12. Corrin, B. and Vijeyaratnam, G.S. (1975) Experimental models of interstitial pneumonia: paraquat, iprindole. Prog. Respir. Res., 8, 107–20.

    Google Scholar 

  13. Addis, B.J. (1990) Diffuse alveolar damage, in The Lungs (ed. B. Corrin), Churchill Livingstone, Edinburgh, pp. 55–68.

    Google Scholar 

  14. Schneeberger-Keeley, E.E. and Karnovsky, M.J. (1968) The ultrastructural basis of alveolar-capillary membrane permeability to peroxidase used as a tracer. J. Cell Biol., 37, 781–93.

    Article  PubMed  CAS  Google Scholar 

  15. Schneeberger, E.E. and Karnovsky, M.J. (1971) The influence of intravascular fluid volume on the permeability of newborn and adult mouse lungs to ultrastructural protein tracers. J. Cell Biol.49, 319–34.

    Article  PubMed  CAS  Google Scholar 

  16. Petty, T.L., Reiss, O.K., Paul, G.N. et al. (1977) Characteristics of pulmonary surfactant in adult respiratory distress syndrome associated with trauma and shock. Am. Rev. Respir. Dis., 15, 531–6.

    Google Scholar 

  17. Bleyl, U. and Rossner, J.A. (1976) Globular hyaline microthrombi — their nature and morphogenesis. Virchows Arch. [A], 370, 113–28.

    CAS  Google Scholar 

  18. Bone, R.C., Francis, PB. and Pierce, A.K. (1976) Intravascular coagulation associated with the adult respiratory distress syndrome. Am. J. Med., 61, 585–9.

    Article  PubMed  CAS  Google Scholar 

  19. Brill, R. and Halpern, M.M. (1948) The frequency of megakaryocytes in autopsy sections. Blood, 3, 286–91.

    PubMed  CAS  Google Scholar 

  20. Tinggaard Pedersen, N. (1974) The pulmonary vessels as a filter for circulating megakaryocytes in rats. Scand. J. Haematol, 13, 225–31.

    Article  Google Scholar 

  21. Tinggaard Pedersen, N. (1978) Occurrence of megakaryocytes in various vessels, and their retention in the pulmonary capillaries of man. Scand. J. Haematol, 21, 379–5.

    Google Scholar 

  22. Trowbridge, E.A., Martin, J.F. and Slater, D.N. (1982) Evidence for a theory of physical fragmentation of megakaryocytes, implying that all platelets are produced in the pulmonary circulation. Thromb. Res., 28, 461–75.

    Article  PubMed  CAS  Google Scholar 

  23. Slater, D.N., Trowbridge, E.A. and Martin J.F. (1983) The megakaryocyte in thrombocytopenia: a microscopic study which supports the theory that platelets are produced in the lungs. Thromb. Res., 31, 163–76.

    Article  PubMed  CAS  Google Scholar 

  24. Sharma, G.K. and Talbot, I.C. (1986) Pulmonary megakaryocytes: ‘missing link’ between cardiovascular and respiratory disease?. J. Clin. Pathol, 39, 969–76.

    Article  PubMed  CAS  Google Scholar 

  25. Crow, J. (1982) Pulmonary haematoxyphil bodies. J. Clin. Pathol, 35, 690–1.

    Article  PubMed  CAS  Google Scholar 

  26. Soares, FA. (1992) Increased numbers of pulmonary megakaryocytes in patients with arterial pulmonary tumour embolism and with lung metastases seen at necropsy. J. Clin. Pathol, 45, 140–2.

    Article  PubMed  CAS  Google Scholar 

  27. Hardaway, R.M. (1973) Disseminated intravascular coagulation as possible cause of acute respiratory failure. Surg. Gynecol. Obstet., 137, 1–5.

    Google Scholar 

  28. Haynes, J.B., Hyers, T.M., Giclas, P.C. et al. (1980) Elevated fibrin(ogen) degradation products in adult respiratory distress syndrome. Am. Rev. Respir. Dis., 122, 841–7.

    PubMed  CAS  Google Scholar 

  29. Sankey, E.A., Crow, J., Mallett, S.V. et al., (1993) Pulmonary platelet aggregates — possible cause of sudden peroperative death in adults undergoing liver transplantation. J. Clin. Pathol, 46, 222–7.

    Article  PubMed  CAS  Google Scholar 

  30. Blaisdell, FW., Lim, R.C. and Stallone, R.J. (1970) The mechanism of pulmonary damage following traumatic shock. Surg. Gynecol Obstet., 130, 15–22.

    PubMed  CAS  Google Scholar 

  31. Clowes, G.H.A. (1974) Pulmonary abnormalities in sepsis. Surg. Clin. North Am., 54, 993–1013.

    PubMed  Google Scholar 

  32. Connell, R.S., Swank, R.L. and Webb M.C. (1975) The development of pulmonary ultra-structural lesions during haemorrhagic shock. J. Trauma. 15, 116–29.

    Article  PubMed  CAS  Google Scholar 

  33. Sandritter, W, Mittesmayer, C., Riede, U.N. et al. (1978) Shock lung syndrome. Ann. Thorac. Surg.162, 7–23.

    CAS  Google Scholar 

  34. Williams, J.H., Patel, S.K., Hatakeyama, D. et al. (1993) Activated pulmonary vascular neutrophils as early mediators of endotoxin-induced lung inflammation. Am. J. Respir. Cell Molec. Biol., 8, 13444.

    Article  Google Scholar 

  35. Rinaldo, J.E. and Rogers, R.M. (1982) Adult respiratory distress syndrome: changing concepts of lung injury and repair. N. Engl J. Med., 306, 900–9.

    Article  PubMed  CAS  Google Scholar 

  36. McGovern, V.J. (1971) Shock. Pathol. Annu., 6, 279–98.

    PubMed  CAS  Google Scholar 

  37. McGovern, V.J. (1972) The pathophysiology of gram-negative septicaemia. Pathology, 4, 265–71.

    Article  PubMed  CAS  Google Scholar 

  38. McGovern, V.J. (1980) Hypovolaemic shock with particular reference to the myocardial and pulmonary lesions. Pathology, 12, 63–72.

    Article  PubMed  CAS  Google Scholar 

  39. Craddock, PR., Hammerschmidt, D.E., White, J.G. et al. (1977) Complement (C5a)-induced granulocyte aggregation in vitro: a possible mechanism of complement-mediated leuko-stasis and leukopenia. J. Clin. Invest., 60, 260–4.

    Article  CAS  Google Scholar 

  40. Tate, R.M. and Repine, J.E. (1983) Neutrophils and the adult respiratory distress syndrome. Am. Rev. Respir. Dis., 128, 552–9.

    PubMed  CAS  Google Scholar 

  41. Cardozo, C., Edelman, J., Jagirdar, J. and Lesser, M. (1991) Lipopolysaccharide-induced pulmonary vascular sequestration of polymorphonuclear leukocytes is complement independent. Am. Rev. Respir. Dis., 144, 173–8.

    Article  PubMed  CAS  Google Scholar 

  42. Stephens, K.E., Ishizaka, A., Larrick, J.W. and Raffin, T.A. (1988) Tumor necrosis factor causes increased pulmonary permeability and edema. Am. Rev. Respir. Dis., 137, 1364–70.

    Article  PubMed  CAS  Google Scholar 

  43. Johnson, J., Brigham, K.L., Jesmok, G. and Meyrick, B. (1991) Morphologic changes in lungs of anesthetized sheep following intravenous infusion of recombinant tumor necrosis factor-alpha. Am. Rev. Respir. Dis., 144, 179–86.

    Article  PubMed  CAS  Google Scholar 

  44. Nash, J.R.G., Mclaughlin, P.J., Hoyle, C. and Roberts D. (1991) Immunolocalization of tumour necrosis factor-alpha in lung tissue from patients dying with adult respiratory distress syndrome. Histopathology, 19, 395–402.

    Article  PubMed  CAS  Google Scholar 

  45. Wegner, CD., Wolyniec, W.W., Laplante, A.M. et al. (1992) Intercellular adhesion molecule-1 contributes to pulmonary oxygen toxicity in mice — role of leukocytes revised. Lung, 170, 267–79.

    Article  PubMed  CAS  Google Scholar 

  46. Moncada, S., Palmer, R.M.J, and Higgs, E.A. (1991) Nitric oxide: physiology, pathophysiology and pharmacology. Pharmacol. Rev., 43, 109–42.

    PubMed  CAS  Google Scholar 

  47. Fleming, I., Gray, G.A., Schott, C. and Stoclet, J. (1991) Inducible but not constitutive production of nitric oxide by vascular smooth muscle cells. Eur. J. Pharmacol, 200, 375–6.

    Article  PubMed  CAS  Google Scholar 

  48. Lui, S.F., Adcock, I.M., Old, R.W. et al. (1993) Lipopolysaccharide treatment in vivo induces widespread tissue expression of inducible nitric oxide synthase mRNA. Biochem. Biophys. Res. Commun., 196, 1208–13.

    Article  Google Scholar 

  49. Evans, M.J., Cabrai, L.J., Stephens, R.J. and Freeman, G. (1973) Renewal of alveolar epithelium in the rat following exposure to N02. Am. J. Pathol, 70, 175–98.

    PubMed  CAS  Google Scholar 

  50. Evan, M.J., Cabrai, L.J., Stephens, R.J. and Freeman, G. (1975) Transformation of alveolar type 2 cells to type 1 cells following exposure to N02. Exp. Mol Pathol, 22, 142–50.

    Article  Google Scholar 

  51. Adamson, I.Y.R. and Bowden, D.H. (1974) The type 2 cells as progenitor of alveolar epithelial regeneration. Lab. Invest., 30, 25–42.

    Google Scholar 

  52. Adamson, I.Y.R. and Bowden, D.H. (1975) Derivation of type 1 epithelium from type 2 cells in the developing rat lung. Lab. Invest., 32, 736–45.

    PubMed  CAS  Google Scholar 

  53. Reidy, M.A. and Schwartz, S.M. (1981) Endothelial regeneration. III. Time course of intimai changes after small defined injury to rat aortic endothelium. Lab. Invest., 44, 301.

    PubMed  CAS  Google Scholar 

  54. Kapanci, Y, Weibel, E.R., Kaplan, H.P. and Robinson, F.R. (1969) Pathogenesis and reversibility of the pulmonary lesions of oxygen toxicity in monkeys. II Ultrastructural and morphometric studies. Lab. Invest., 20, 101–18.

    PubMed  CAS  Google Scholar 

  55. Tomashefski, J.F., Davies, P. Boggis, C. et al. The pulmonary vascular lesions of the adult respiratory distress syndrome. Am. J. Pathol, 112, 112–6.

    Google Scholar 

  56. Bachofen, M. and Weibel, E.R. (1974) Basic pattern of tissue repair in human lungs following unspecific injury. Chest, 65 (suppl.), 14s–19s.

    Article  Google Scholar 

  57. Fukuda, Y, Ishizaki, M., Masud, Y et al. (1987) The role of intraalveolar fibrosis in the process of pulmonary structural remodeling in patients with diffuse alveolar damage. Am. J. Pathol, 126, 171–82.

    PubMed  CAS  Google Scholar 

  58. Zapol, W.M., Trelstad, R.L., Coffey, J.W. et al. (1979) Pulmonary fibrosis in severe acute respiratory failure. Am. Rev. Respir. Dis., 119, 547–54.

    PubMed  CAS  Google Scholar 

  59. Brody, A.R. and Craighead, J.E. (1976) Interstitial associations of cells lining air spaces in human pulmonary fibrosis. Virchows Arch. [A], 372, 39–49.

    CAS  Google Scholar 

  60. Brody, A.R., Soler, P., Basset, F. et al. (1981) Epithelial-mesenchymal associations of cells in human pulmonary fibrosis and in BHT-oxygen-induced fibrosis in mice. Exp. Lung Res., 2, 207–20.

    Article  PubMed  CAS  Google Scholar 

  61. Adamson, I.Y.R., Young, L. and Bowden, D.H. (1988) Relationship of alveolar epithelial injury and repair to the induction of pulmonary fibrosis. Am. J. Pathol, 130, 377–83.

    PubMed  CAS  Google Scholar 

  62. Adamson, I.Y.R., Hedgecock, C. and Bowden, D.H. (1990) Epithelial cell-fibroblast interactions in lung injury and repair. Am. J. Pathol, 137, 385–92.

    PubMed  CAS  Google Scholar 

  63. Fukuda, Y, Ferrans, V.J., Schoenbergeri, C.I. et al. (1985) Patterns of pulmonary structural remodeling after experimental paraquat toxicity. Am. J. Pathol, 452, 452–75.

    Google Scholar 

  64. Katzenstein, A.A. (1985) Pathogenesis of ‘fibrosis’ in interstitial pneumonia: an electron microscopic study. Hum. Pathol, 16, 1015–24.

    Article  PubMed  CAS  Google Scholar 

  65. Burkhardt, A. (1986) Pathogenesis of pulmonary fibrosis. Hum. Pathol., 17, 971–3.

    Article  PubMed  CAS  Google Scholar 

  66. Burkhardt, A. (1989) Alveolitis and collapse in the pathogenesis of pulmonary fibrosis. Am. Rev. Respir. Dis., 140, 513–24.

    Article  PubMed  CAS  Google Scholar 

  67. Churg, A., Golden, J., Fligiel, S. and Hogg, J.C. (1983) Bronchopulmonary dysplasia in the adult. Am. Rev. Respir. Dis., 127, 117–20.

    PubMed  CAS  Google Scholar 

  68. Wohl, M.E.B. (1990) Bronchopulmonary dysplasia in adulthood. N. Engl. J. Med., 323, 1834–6.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Bryan Corrin
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Editors and Affiliations

  1. National Heart & Lung Institute, USA

    Timothy W. Evans MD, FRCP, PhD (Reader in Critical Care Medicine, Consultant in Thoracic and Intensive Care Medicine) (Reader in Critical Care Medicine, Consultant in Thoracic and Intensive Care Medicine)

  2. Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK

    Timothy W. Evans MD, FRCP, PhD (Reader in Critical Care Medicine, Consultant in Thoracic and Intensive Care Medicine) (Reader in Critical Care Medicine, Consultant in Thoracic and Intensive Care Medicine)

  3. University of Edinburgh, Royal Infirmary, Lauriston Place, Edinburgh, EH3 9YW, UK

    Christopher Haslett FRCP, FRCP (Edin) (Professor of Respiratory Medicine, Chairman of the Department of Medicine (RIE) and Director of the Rayne Laboratories) (Professor of Respiratory Medicine, Chairman of the Department of Medicine (RIE) and Director of the Rayne Laboratories)

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© 1996 Springer Science+Business Media Dordrecht

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Corrin, B. (1996). Diffuse Alveolar Damage. In: Evans, T.W., Haslett, C. (eds) ARDS Acute Respiratory Distress in Adults. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-3430-7_4

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  • DOI: https://doi.org/10.1007/978-1-4899-3430-7_4

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-412-56910-4

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