Pathophysiology of Acute Respiratory Distress Syndrome and COVID-19 Lung Injury

The pathophysiology of acute respiratory distress syndrome (ARDS) is marked by inflammation-mediated disruptions in alveolar-capillary permeability, edema formation, reduced alveolar clearance and collapse/derecruitment, reduced compliance, increased pulmonary vascular resistance, and resulting gas...

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Bibliographic Details
Published inCritical care clinics Vol. 37; no. 4; p. 749
Main Authors Swenson, Kai Erik, Swenson, Erik Richard
Format Journal Article
LanguageEnglish
Published United States 01.10.2021
Subjects
COVID-19
Humans
Lung
Lung Injury - etiology
Respiration, Artificial - adverse effects
Respiratory Distress Syndrome - etiology
Respiratory Distress Syndrome - therapy
SARS-CoV-2
COVID-19
acute respiratory distress syndrome
pathophysiology
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Summary:The pathophysiology of acute respiratory distress syndrome (ARDS) is marked by inflammation-mediated disruptions in alveolar-capillary permeability, edema formation, reduced alveolar clearance and collapse/derecruitment, reduced compliance, increased pulmonary vascular resistance, and resulting gas exchange abnormalities due to shunting and ventilation-perfusion mismatch. Mechanical ventilation, especially in the setting of regional disease heterogeneity, can propagate ventilator-associated injury patterns including barotrauma/volutrauma and atelectrauma. Lung injury due to the novel coronavirus SARS-CoV-2 resembles other causes of ARDS, though its initial clinical characteristics may include more profound hypoxemia and loss of dyspnea perception with less radiologically-evident lung injury, a pattern not described previously in ARDS.
ISSN:1557-8232
DOI:10.1016/j.ccc.2021.05.003