Late adult respiratory distress syndrome.

摘要: Abstract Late adult respiratory distress syndrome (ARDS) refers to the clinical stage of ARDS when lung attempts repair initial or persistent injury endothelial and epithelial lining units. Histologically, it is characterized by replacement damaged cells striking accumulation mesenchymal (fibroproliferative phase) their connective tissue products in air spaces walls intra-acinar microvessels. Unfortunately, this reparative process frequently ineffective, leading directly indirectly patient's death. Its evolution appears be determined extent insult presence a protracted inflammatory response. Continuous may result from release cytokines lung. In late ARDS, surface pathogenic mechanism behind bronchoalveolar lavage neutrophilia diffuse pulmonary uptake gallium. Ineffective progressive proliferation myofibroblast deposition collagen alveoli, thereby producing worsening gas exchange mechanics. Prolonged mechanical ventilation predisposes patient development extrapulmonary infections. Moreover, with fibroproliferation causes fever leukocytosis, making distinction infections difficult, if not impossible. Anecdotal reports suggest that corticosteroid treatment accelerate recovery ARDS.