Abstract
The adult respiratory distress syndrome (ARDS) is an acute respiratory failure due to non-hemodynamic pulmonary edema, also called permeability edema. It is a common complication of several critical diseases such as circulatory shock, sepsis and trauma. The clinical picture includes hypoxemia, decreased lung compliance and diffuse bilateral infiltrates on chest roentgenogram. The arterial hypoxemia in ARDS mainly results from intrapulmonary shunt due to perfusion of unventilated lung units.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Zapol WM, Snider MT, Rie MA, Quinn DA, Fikker M (1985) Pulmonary circulation during adult pulmonary distress syndrome. In: Zapol WM, Falke KJ (eds) Acute respiratory failure, vol 24. Dekker, New York, pp 241–273
Mitzner W, Chang HK (1989) Hemodynamics of the pulmonary circulation. In: Chang HK, Paiva M (eds) Respiratory physiology. An analytical approach, vol 40. Dekker, New York, pp 561–631
SooHoo SL, Goldberg HS, Graham R, Jasper AC (1987) Zone 2 and zone 3 pulmonary blood flow. J Appl Physiol 62:1982–1988
Boiteau P, Ducas J, Schick U, Girling L, Prewitt RM (1986) Pulmonary vascular pressure:flow relationship in canine oleic acid pulmonary edema. Am J Physiol 251:HI 163–HI 170
Leeman M, Closset J, Vachiery JL, Lejeune P, Melot C, Naeije R (1989) Sinoaortic deafferentation reduces intrapulmonary shunt in dogs with oleic acid lung injury. J Appl Physiol 67:833–838
Leeman M, Lejeune P, Melot C, Naeije R (1988) Pulmonary vascular pressure:flow plots in canine oleic acid pulmonary edema. Effects of prostaglandin El and nitroprusside. Am Rev Respir Dis 138:362–367
Greene R, Zapol WM, Snider MT, Reid L, Snow R, O’Connell RS, Novelline RA (1981) Early bedside detection of pulmonary vascular occlusion during acute respiratory failure. Am Rev Respir Dis 124:593–601
Tomashefski JF, Davies P, Boggis C, Greene R, Zapol WM, Reid LM (1983) The pulmonary vascular lesions of the adult respiratory distress syndrome. Am J Pathol 112:112–126
Bachofen M, Weibel E (1982) Structural alterations of lung parenchyma in the adult respiratory distress syndrome. Clin Chest Med 3:35–56
Snow RL, Davies P, Pontoppidan H, Zapol WM, Reid L (1982) Pulmonary vascular remodeling in adult respiratory distress syndrome. Am Rev Respir Dis 126:887–892
Michel RP, Zocchi L, Rossi A, et al (1987) Does interstitial lung edema compress airways and arteries? A morphometric study. J Appl Physiol 62:108–115
Bhattacharya J, Nakahara K, Staub NC (1980) Effect of edema on pulmonary blood flow in the isolated perfused dog lung lobe. J Appl Physiol 48:444–449
Ali J, Wood LDH (1986) Factors affecting perfusion distribution in canine oleic acid pulmonary edema. J Appl Physiol 60:1498–1503
Radermacher P, Huet Y, Pluskwa F, Herigault R, Mal H, Teisseire B, Lemaire F (1988) Comparison of ketanserin and sodium nitroprusside in patients with severe ARDS. Anesthesiology 68:152–157
Melot C, Naeije R, Mols P, Hallemans R, Lejeune P, Jaspar N (1987) Pulmonary vascular tone improves gas exchange in the adult respiratory distress syndrome. Am Rev Respir Dis 136:1232–1236
Melot C, Lejeune P, Leeman M, Moraine JJ, Naeije R (1989) Prostaglandin El in the adult respiratory distress syndrome. Benefit for pulmonary hypertension and cost for pulmonary gas exchange. Am Rev Respir Dis 139:106–110
Prewitt RM, McCarthy J, Wood LDH (1981) Treatment of acute low pressure pulmonary edema in dogs. Relative effects of hydrostatic and oncotic pressure, nitroprusside, and positive end-expiratory pressure. J Clin Invest 67:409–418
Garrett RC, Thomas III HM (1983) Meclofenamate uniformly decreases shunt fraction in dogs with lobar atelectasis. J Appl Physiol 54:284–289
Light RB (1986) Indomethacin and acetylsalicylic acid reduce intrapulmonary shunt in experimental pneumococcal pneumonia. Am Rev Respir Dis 134:520–525
Ali J, Duke K (1987) Does indomethacin affect shunt and its response to PEEP in oleic acid pulmonary edema? J Appl Physiol 62:2187–2192
Leeman M, Lejeune P, Hallemans R, Melot C, Naeije R (1988) Effects of increased pulmonary vascular tone on gas exchange in canine oleic acid pulmonary edema. J Appl Physiol 65:662–668
Schulman LL, Lennon PF, Ratner SJ, Enson Y (1988) Meclofenamate enhances blood oxygenation in acute oleic acid lung injury. J Appl Physiol 64:710–718
Reyes A, Roca J, Rodriguez-Roisin R, Torres A, Ussetti P, Wagner PD (1988) Effect of almitrine on ventilation-perfusion distribution in adult respiratory distress syndrome. Am Rev Respir Dis 137:1062–1067
Nakanishi S, Hiramoto T, Ahmed N, Nishimoto Y (1988) Almitrine enhances in low dose the reactivity of pulmonary vessels to hypoxia. Respir Physiol 74:139–150
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1990 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Leeman, M. (1990). Pulmonary Hypertension in ARDS. In: Vincent, J.L. (eds) Update 1990. Update in Intensive Care and Emergency Medicine, vol 10. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84125-5_29
Download citation
DOI: https://doi.org/10.1007/978-3-642-84125-5_29
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-52269-0
Online ISBN: 978-3-642-84125-5
eBook Packages: Springer Book Archive