Acute respiratory distress syndrome in Trauma

Posted by e-Medical PPT Tuesday, July 13, 2010

Acute respiratory distress syndrome (ARDS) is associated with diffuse alveolar damage and lung capillary endothelial injury.
Early ARDS is characterized by an increase in the permeability of the alveolar-capillary barrier leading to an influx of fluid into the alveoli.The insults resulting in damage either to the vascular endothelium (eg, sepsis) or to the alveolar epithelium(eg, aspiration of gastric contents). could result in ARDS.
Injury to the endothelium results in increased capillary permeability and the influx of protein-rich fluid into the alveolar space. Injury to the alveolar lining cells also promotes pulmonary edema formation. Two types of alveolar epithelial cells exist. Type I cells, comprising 90% of the alveolar epithelium, are injured easily. Damage to type I cells allows both increased entry of fluid into the alveoli and decreased clearance of fluid from the alveolar space.Damage to type II cells results in decreased production of surfactant with resultant decreased compliance and alveolar collapse. Interference with the normal repair processes in the lung may lead to the development of fibrosis.
Neutrophils are thought to play an important role in the pathogenesis of ARDS.
Cytokines, such as tumor necrosis factor (TNF), leukotrienes, macrophage inhibitory factor,along with platelet sequestration and activation, also are important in the development of ARDS.
ARDS is uniformly associated with pulmonary hypertension. Pulmonary artery vasoconstriction likely contributes to ventilation-perfusion mismatch and is one of the mechanisms of hypoxemia in ARDS. Normalization of pulmonary artery pressures occurs as the syndrome resolves. The development of progressive pulmonary hypertension is associated with a poor prognosis.
ARDS in Children

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1 Response to Acute respiratory distress syndrome in Trauma

  1. Anonymous Says:
  2. Acute rspiratory distress syndrome in trauma, It was a good and interresting presentation


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