Pathophysiology of Unresolving ARDS: The Role of the Host Defense Response

  • G. U. Meduri
Conference paper


Acute respiratory distress syndrome (ARDS) describes the clinical syndrome associated with the morphologic lesion termed diffuse alveolar damage (DAD). At presentation, early ARDS manifests with acute and diffuse injury to the endothelial and epithelial linings of the terminal respiratory units and causes increased vascular permeability with protein-rich exudative oedema. In nonsurvivors of ARDS, DAD rapidly advances through three histological phases (exudative, fibroproliferative, and fibrotic) with different clinico-physiological features. The objective of this review is to describe systematically the pathophysiology of unresolving ARDS relating to mechanisms of its development, structural alterations induced in the lung, and functional consequences of these morphologic changes.


Acute Respiratory Distress Syndrome Disseminate Intravascular Coagulation Acute Respiratory Failure Multiple Organ Dysfunction Syndrome Adult Respiratory Distress Syndrome 


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© Springer-Verlag Italia 1999

Authors and Affiliations

  • G. U. Meduri
    • 1
  1. 1.Dept. of Medicine, Division of Pulmonary and Critical CareThe University of TennesseeMemphisUSA

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