Abstract
Adult respiratory distress syndrome (ARDS) is a frequent cause of death in intensive care units and probably represents a collection of different conditions. In the complex issue of its aetiology the failure to define terms has led in our opinion to considerable confusion. It is doubtful whether the pulmonary failure that follows viral pneumonia or specific lung infections has the same pathophysiology as that following 3 days after massive blood transfusion, although both may share similar X-ray features and be called “ARDS”. In this chapter “shock” refers to that condition in which there is a failure of the circulation of blood to meet the metabolic needs of the tissues. “Shock lung” is defined here as pulmonary failure without left ventricular failure typified by increased pulmonary arteriovenous admixture and widespread opacification of the lung fields on X-ray, developing as a consequence of and at an interval of hours or days following an episode of shock or severe sepsis. In this way we may concentrate entirely on that variety of ARDS that almost certainly has a common, although possibly multiple, cause that was almost certainly active during the episode of shock. The delay before pulmonary failure develops is a consistent feature of great importance in understanding the pathophysiology.
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
Attar S, Mansberger AR, Irani B, Kirby W, Masaitis C, Cowley RA (1966) Coagulation changes in clinical shock. II. Effect of septic shock on clotting times and fibrinogen in humans. Ann Surg 164:41–50.
Bailey ME (1976) Endotoxin, bile salts and renal function in obstructive jaundice. Br J Surg 63:774–778.
Bergofsky EH (1970) The adult acute respiratory insufficiency syndrome following non-thoracic trauma: the lung in shock. Am J Cardiol 26:619–621.
Blaisdell FW, Lewis FR (1977) Respiratory distress syndrome of shock and trauma. WB Saunders, Philadelphia.
Blaisdell FW, Lim RC, Stallone RJ (1970) The mechanism of pulmonary damage following traumatic shock. Surg Gynecol Obstet 130:15–22.
Bredenberg CE, Taylor GA, Webb WR (1980) The effect of thrombocytopenia on the pulmonary and systemic hemodynamics in canine endotoxin shock. Surgery 87:59–68.
Brown C, Dhurandhar HN, Barrett J, Litwin MS (1977) Progression and resolution of changes in pulmonary function and structure due to pulmonary microembolism and blood transfusion. Ann Surg 185:92–99.
Clowes GHA, Fabbington GH, Zuschneid W, Cossette GR, Saravin C (1970) Circulating factors in the etiology of pulmonary insufficiency and right heart failure accompanying severe sepsis (peritonitis). Ann Surg 171:663–678.
Collins JA (1969) The cause of progressive pulmonary insufficiency in surgical patients. J Surg Res 9:685–704.
Collins JA, James PM, Bredenberg CE, Anderson RW, Heisterkamp CA, Simmons RL (1978) The relationship between transfusion and hypoxaemia in combat casualties. Ann Surg 188:513–520.
Cook WA, Webb WR (1968) Pulmonary changes in haemorrhagic shock. Surgery 64:85–94.
Craddock PR, Fehr J, Brigham KL, Kronenberg RS, Jacob HS (1977) Complement and leukocytemediated pulmonary dysfunction in haemodialysis. N Engl J Med 296:769–774.
Del Guercia LR, Cohn JD, Greenspan M, Feins NR, Kornitzer G (1966) Pulmonary and systemic arteriovenous shunting in clinical septic shock. In: Brown IW, Cox BG (eds) International conference on hyperbaric medicine. National Academic Science, Durham NC.
Diament ML, Palmer KNV (1967) Venous/arterial pulmonary shunting as the principal cause of postoperative hypoxaemia. Lancet 1:15–17.
Drummond GB (1975) Postoperative hypoxaemia and oxygen therapy. Br J Anaesth 47:211–228.
Fuchsig F, Brucke P, Blumel G, Gottlob R (1967) A new clinical and experimental concept of fat embolism. N Engl J Med 276:1192–1193.
Geelhoed GW, Bennett SH (1975) “Shock lung” resulting from perfusion of canine lungs with stored bank blood. Am Surg 41:661–682.
Greenhall MJ, Evans M, Pollock AV (1980) Midline or transverse laparotomy? A random controlled clinical trial. II. Influence on postoperative pulmonary complications. Br J Surg 67:191–194.
Hammerschmidt DE, Weaver LJ, Hudson LD, Craddock PR, Jacob HS (1980) Association of complement activation and elevated plasma-C5a with adult respiratory distress syndrome: pathophysiological relevance and possible prognostic value. Lancet 1:947–949.
Hardaway RM (1962) The role of intravascular clotting in the aetiology of shock. Ann Surg 155:325–338.
Hardaway RM, Husni EA, Geever EF, Noyes HE, Burns JW (1961) Endotoxin shock: a manifestation of intravascular coagulation. Ann Surg 154:791–802.
Harrison MW, Connel RS, Campbell JR, Webb MC (1977) Microcirculatory changes in the lung of the hypoxic and hypovolaemic puppy. Ann Surg 185:311–317.
Hawker RJ, Hawker LM, Wilkinson AR (1980) Indium (III-In)-labelled human platelets: optimal method. Clin Sci 58:243–248.
Hewson W (1772) In: The works of William Hewson FRS, ed G Gulliver. Sydenham Society, London (1846).
Hissen W, Swank RL (1965) Screen filtration pressure and pulmonary hypertension. Am J Physiol 209:715–722.
Jacob HS (1978) Granulocyte-complement interaction. A beneficial antimicrobial mechanism that can cause disease. Arch Intern Med 138:461–463.
Krahl VE (1965) The lung as a target organ in thromboembolism. In: Sasahara AA (ed) Pulmonary embolic disease. Grune and Stratton, New York.
Lillehei RC, Longerbeam JK, Bloch JH, Manax WG (1964) The nature of irreversible shock. Ann Surg 160:682–710.
Lim RC, Blaisdell FW, Goodman JR, Hall AD, Thomas AN (1966) Electron microscopic study of pulmonary microemboli in regional and systemic shock. Surg Forum 17:25–27.
McCollum CN, Campbell IT (1979) Value of measuring intravascular platelet aggregates in the prediction of post-operative pulmonary dysfunction. Br J Surg 66:703–707.
McNamara JJ, Burran EL, Larson E, Omiya G, Suehire G, Yamase H (1972) Effect of debris in stored blood on pulmonary microvasculature. Ann Thorac Surg 14:133–139.
Modry DL, Chiu CJ, Jinchey EJ (1977) The roles of ventilation and perfusion in lung metabolism. J Thorac Cardiovasc Surg 74:275–285.
Moore FD, Lyons JH, Pierce EC, Morgan AP, Drinker PA, MacArthur JD, Dammin GJ (1969) Posttraumatic pulmonary insufficiency. WB Saunders, Philadelphia.
Moseley RV, Doty DB (1970) Death associated with multiple pulmonary emboli soon after battle injuries. Ann Surg 171:336–346.
Murray JF (1977) Mechanisms of acute respiratory failure. Am Rev Respir Dis 115:1071–1078.
Nahas RA, Melrose DG, Sykes KM, Robinson B (1965) Post-perfusion lung syndrome: role of circulatory exclusion. Lancet 11:251–254.
Nash G, Bowen JA, Langlinais PC (1971) Respirator lung, a misnomer. Arch Pathol 21:234–240.
Pardy BJ, Dudley HAF (1977) Post-traumatic pulmonary insufficiency. Surg Gynecol Obstet 144:259–269.
Powell JP, Poskitt KR, Irwin JTC, Attanoos RL, McCollum CN (1986) Opsonic dysfunction secondary to plasma fibronectin depletion after aortic surgery. Br J Surg 73:38–40.
Robb HJ (1963) The role of microembolism in the production of irreversible shock. Ann Surg 175:685–697.
Shah-Mirany J, Najafi H, Serry C, Callaghan R, Yang J (1970) Pathophysiological alterations in perfused and non-perfused lungs during cardiopulmonary bypass. Ann Thorac Surg 10:402–408.
Simmons RL, Ducker TD, Anderson RW (1968) Pathogenesis of pulmonary oedema following head trauma. J Trauma 8:800–811.
Stein M, Thomas DP (1967) Role of platelets in the acute pulmonary response to endotoxin. J Appl Physiol 23:47–52.
Swank RL (1961) Alteration of blood on storage: measurement of adhesiveness of aging platelets and leukocytes and their removal by filtration. N Engl J Med 265:728–733.
Tiefenbrun J, Dikman S, Shoemaker WC (1975) The correlation of sequential changes in the distribution of pulmonary blood flow in haemorrhagic shock with the histopathologic anatomy. Surgery 78:618–627.
Ygge J (1970) Changes in blood coagulation and fibrinolysis during the postoperative period. Am J Surg 119:225–232.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1988 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
McCollum, C.N., Poskitt, K.R. (1988). Intravascular Microaggregates and Pulmonary Embolization in Shock and Surgery. In: Kox, W., Bihari, D. (eds) Shock and the Adult Respiratory Distress Syndrome. Current Concepts in Critical Care. Springer, London. https://doi.org/10.1007/978-1-4471-1443-7_4
Download citation
DOI: https://doi.org/10.1007/978-1-4471-1443-7_4
Publisher Name: Springer, London
Print ISBN: 978-1-4471-1445-1
Online ISBN: 978-1-4471-1443-7
eBook Packages: Springer Book Archive