Current opinion in critical care
-
Curr Opin Crit Care · Feb 2008
ReviewWhat have anatomic and pathologic studies taught us about acute lung injury and acute respiratory distress syndrome?
Acute lung injury and acute respiratory distress syndrome are defined as morphologic and functional manifestations of pulmonary injury of various causes. Acute lung injury and acute respiratory distress syndrome may result from direct effects on epithelial lung cells or from indirect effects on endothelial lung cells, reflecting lung involvement as part of a more distant systemic inflammatory response. This review addresses anatomic/pathologic differences between acute lung injury and acute respiratory distress syndrome lungs. ⋯ An appreciation of the acute respiratory distress syndrome must take into account anatomic/pathologic characteristics, which depend upon the initial cause. Consideration of each pathologic mechanism will permit more precise clinical management and probably improved outcomes.
-
Curr Opin Crit Care · Feb 2008
ReviewThe epithelium in acute lung injury/acute respiratory distress syndrome.
The mechanisms of epithelial injury in acute lung injury/acute respiratory distress syndrome have been of interest since the syndrome was first described. Cell therapies to replace injured epithelium are a futuristic dream; however, there is ongoing research to achieve this goal. We review research regarding the function of the epithelium in acute lung injury/acute respiratory distress syndrome, including potential novel therapies. ⋯ Epithelial damage is a hallmark of acute lung injury/acute respiratory distress syndrome. An increased understanding of the function of these cells and of the abnormalities that occur when these lung cells are injured should allow the development of novel therapies and, perhaps, lead to replacement therapies.
-
Lymph flow will be discussed as part of the drainage and fluid balance of lung tissue and abdomen as well as a qualitative analysis of inflammatory processes. ⋯ Lymph flow measurements are still a difficult task to perform; however, new results show an important function in the fluid balance of the lung and abdomen. Inflammatory spread may occur from the lung to the periphery by the blood stream and from the abdomen to the lung by lymph flow.